Janghorbani Mohsen, Amini Masoud
Isfahan Endocrine and Metabolism Research Center, Isfahan, Iran.
Ann Nutr Metab. 2016;68(1):19-25. doi: 10.1159/000441851. Epub 2015 Nov 12.
BACKGROUND/AIM: It is not clear whether levels of continuous metabolic syndrome (cMetS) are associated with type 2 diabetes (T2D). The aim of this study was to determine the ability of the cMetS score to predict progression to T2D in non-diabetic first-degree relatives (FDRs) of patients with T2D in Isfahan, Iran.
A total of 1,869 non-diabetic FDRs 30-70 years old in 2003-2005 were followed through 2014 for the occurrence of T2D. At baseline and through follow-ups, participants underwent a standard 75 g 2-h oral glucose tolerance test. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III. The cMetS score was calculated using age- and gender-standardized Z-score for MetS components. Receiver operating characteristic (ROC) curve was used to assess the association between cMetS and components of MetS with T2D.
During 13,571 person-years of follow-up, 72 men and 210 women developed diabetes. Those in the top quartile of cMetS were 8.0 times more likely to develop diabetes than those in the bottom quartile (OR 7.96; 95% CI 4.88-12.99). On ROC curve analysis, a higher area under the ROC were found for FPG (74.3%; 95% CI 70.8-77.8), than for cMetS (69.4%; 95% CI 66.0-72.8).
The cMetS score is a robust predictor of T2D and may be more effective and efficient than the current binary definition of MetS in predicting progression to T2D in our study population.
背景/目的：尚不清楚持续性代谢综合征（cMetS）水平是否与2型糖尿病（T2D）相关。本研究的目的是确定cMetS评分预测伊朗伊斯法罕T2D患者非糖尿病一级亲属（FDRs）进展为T2D的能力。
2003年至2005年共纳入1869名30至70岁的非糖尿病FDRs，随访至2014年观察T2D的发生情况。在基线和随访期间，参与者接受标准的75g 2小时口服葡萄糖耐量试验。代谢综合征（MetS）由美国国家胆固醇教育计划成人治疗小组第三次报告定义。cMetS评分采用MetS各组分的年龄和性别标准化Z评分计算。采用受试者工作特征（ROC）曲线评估cMetS及MetS各组分与T2D的相关性。
在13571人年的随访期间，72名男性和210名女性患糖尿病。cMetS处于最高四分位数的人群患糖尿病的可能性是最低四分位数人群的8.0倍（比值比7.96；95%可信区间4.88-12.99）。ROC曲线分析显示，空腹血糖（FPG）的ROC曲线下面积较高（74.3%；95%可信区间70.8-77.8），高于cMetS（69.4%；95%可信区间66.0-72.8）。
cMetS评分是T2D的有力预测指标，在预测本研究人群进展为T2D方面可能比目前的MetS二元定义更有效。
