Kompoti Maria, Mariolis Anargiros, Alevizos Alevizos, Kyrazis Ioannis, Protopsaltis Ioannis, Dimou Eleni, Lentzas Ioannis, Levisianou Dimitrios, Gova Afroditi, Melidonis Andreas
Department of General Practice/Family Medicine, Health Centre of Vyronas, Athens, Greece.
Cardiovasc Diabetol. 2006 Oct 4;5:21. doi: 10.1186/1475-2840-5-21.
Patients with diabetes already fulfill one diagnostic criterion for MS according to the existing classifications. Our aim was to identify one single clinical parameter, which could effectively predict the presence of MS in patients with type 2 diabetes.
We studied all patients with type 2 diabetes who attended our Diabetes Outpatient Clinic during a three-month period. Waist circumference, blood pressure and serum lipids were measured. Establishment of MS diagnosis was based a) on National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria and b) on International Diabetes Federation (IDF) criteria. Receiver operating characteristic (ROC) analysis was applied in order to identify the clinical parameter with the highest predictive capability for MS. Among the 500 participating patients (231 males, 269 females), MS was diagnosed in 364 patients (72.8%) according to the NCEP ATP III criteria and in 408 patients (81.6%) according to the IDF criteria.
For the NCEP ATP III classification, serum triglycerides (in the overall population), waist and HDL (in female population) demonstrated the highest predictive capability for MS (AUCs:0.786, 0.805 and 0.801, respectively). For the IDF classification, no single parameter reached an AUC > 0.800 in the overall population. In females, HDL displayed a satisfactory predictive capability for MS with an AUC which was significantly higher than the one in males (0.785 vs. 0.676, respectively, p < 0.05).
Elevated serum triglycerides strongly indicate the presence of MS in patients with type 2 diabetes. In female patients with type 2 diabetes, central obesity was the second stronger predictor of MS besides hypertriglyceridemia.
根据现有分类，糖尿病患者已符合代谢综合征（MS）的一项诊断标准。我们的目的是确定一个单一的临床参数，该参数能够有效预测2型糖尿病患者是否存在MS。
我们研究了在三个月期间到我们糖尿病门诊就诊的所有2型糖尿病患者。测量了腰围、血压和血脂。MS诊断的确定基于：a）美国国家胆固醇教育计划成人治疗组第三次报告（NCEP ATP III）标准；b）国际糖尿病联盟（IDF）标准。应用受试者工作特征（ROC）分析以确定对MS具有最高预测能力的临床参数。在500名参与研究的患者（231名男性，269名女性）中，根据NCEP ATP III标准，364名患者（72.8%）被诊断为MS，根据IDF标准，408名患者（81.6%）被诊断为MS。
对于NCEP ATP III分类，血清甘油三酯（在总体人群中）、腰围和高密度脂蛋白（HDL，在女性人群中）对MS显示出最高的预测能力（曲线下面积[AUC]分别为：0.786、0.805和0.801）。对于IDF分类，在总体人群中没有单一参数的AUC>0.800。在女性中，HDL对MS显示出令人满意的预测能力，其AUC显著高于男性（分别为0.785和0.676，p<0.05）。
血清甘油三酯升高强烈提示2型糖尿病患者存在MS。在2型糖尿病女性患者中，除高甘油三酯血症外，中心性肥胖是MS的第二强预测因素。
