Cheung Bernard M Y, Wat Nelson M S, Man Yu Bun, Tam Sidney, Thomas G Neil, Leung Gabriel M, Cheng Chun Ho, Woo Jean, Janus Edward D, Lau Chu Pak, Lam Tai Hing, Lam Karen S L
Department of Medicine, University of Hong Kong, Hong Kong, China.
Diabetes Care. 2007 Jun;30(6):1430-6. doi: 10.2337/dc06-1820. Epub 2007 Mar 2.
We investigated the association of the metabolic syndrome with new-onset diabetes in the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort.
We followed up on 1,679 subjects without diabetes at baseline. Those with a previous diagnosis of diabetes or those who were receiving drug treatment were considered to be diabetic. The remaining subjects underwent a 75-g oral glucose tolerance test (OGTT). Diabetes was defined by plasma glucose > or =7.0 mmol/l with fasting and/or > or =11.1 mmol/l at 2 h.
The prevalences of the metabolic syndrome at baseline were 14.5 and 11.4%, respectively, according to U.S. National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) criteria. After a median of 6.4 years, there were 66 and 54 new cases of diabetes in men and women, respectively. The metabolic syndrome at baseline predicted incident diabetes. Hazard ratios (HRs) for the NCEP and IDF definitions of the syndrome were 4.1 [95% CI 2.8-6.0] and 3.5 [2.3-5.2], respectively. HRs for fasting plasma glucose (FPG) > or =6.1 or 5.6 mmol/l were 6.9 [4.1-11.5] and 4.1 [2.8-6.0], respectively. The NCEP and IDF criteria had 41.9 and 31.7% sensitivity and 87.5 and 90.2% specificity, respectively. Their positive predictive values were low, approximately 20%, but their negative predictive values were approximately 95%.
The metabolic syndrome, particularly its component, elevated FPG, predicts diabetes in Chinese. An individual without the metabolic syndrome is unlikely to develop diabetes, but one who has it should practice therapeutic lifestyle changes and have periodic FPG measurements to detect new-onset diabetes.
在香港心血管危险因素患病率研究队列中，我们调查了代谢综合征与新发糖尿病之间的关联。
我们对1679名基线时无糖尿病的受试者进行了随访。既往诊断为糖尿病或正在接受药物治疗的患者被视为糖尿病患者。其余受试者接受75克口服葡萄糖耐量试验（OGTT）。糖尿病的定义为空腹血糖≥7.0毫摩尔/升和/或2小时血糖≥11.1毫摩尔/升。
根据美国国家胆固醇教育计划（NCEP）和国际糖尿病联盟（IDF）的标准，基线时代谢综合征的患病率分别为14.5%和11.4%。中位随访6.4年后，男性和女性分别有66例和54例新发糖尿病病例。基线时的代谢综合征可预测糖尿病的发生。该综合征的NCEP和IDF定义的风险比（HR）分别为4.1[95%可信区间2.8 - 6.0]和3.5[2.3 - 5.2]。空腹血糖（FPG）≥6.1或5.6毫摩尔/升的HR分别为6.9[4.1 - 11.5]和4.1[2.8 - 6.0]。NCEP和IDF标准的敏感性分别为41.9%和31.7%，特异性分别为87.5%和90.2%。它们的阳性预测值较低，约为20%，但阴性预测值约为95%。
代谢综合征，尤其是其组成部分空腹血糖升高，可预测中国人患糖尿病的情况。无代谢综合征的个体不太可能患糖尿病，但患有代谢综合征的个体应改变治疗性生活方式并定期测量空腹血糖以检测新发糖尿病。
