Saif-Ali Riyadh, Kamaruddin Nor Azmi, Al-Habori Molham, Al-Dubai Sami A, Ngah Wan Zurinah Wan
Biochemistry Department, Faculty of Medicine, Sana'a University, Sana'a, Yemen.
Internal Medicine, UKM Medical Centre, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Diabetol Metab Syndr. 2020 Aug 5;12:67. doi: 10.1186/s13098-020-00575-7. eCollection 2020.
The chronic complications of Type 2 Diabetes (T2D) such as macrovascular disease is amplified with the increase in the number of metabolic syndrome (MetS) risk factors. This research aims to study the relationship of MetS, diagnosed by the International Diabetes Federation (IDF) or revised National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP III) criteria, with glycemic control, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), C-peptide, and insulin resistance in T2D patients.
The study is a cross-sectional observational study which, involved 485 T2D patients who are receiving treatment at the University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. The MetS among the T2D patients was diagnosed based on IDF and revised NCEP ATP III criteria. C-peptide and HbA1c levels were determined by an automated quantitative immunoassay analyzer and high-performance liquid chromatography, respectively. The MetS factors; FBG, triglyceride, and high-density lipoprotein cholesterol were measured by spectrophotometer.
Application of the IDF and revised NCEP ATP III criteria respectively resulted in 73% and 85% of the T2D subjects being diagnosed with MetS. The concordance of these criteria in diagnosing MetS among T2D patients was low (κ = 0.33, < 0.001). Both IDF and revised NCEP ATP III criteria indicated that T2D patients with 5 MetS factors had higher insulin resistance (= 2.1 × 10; 1.4 × 10), C-peptide (= 1.21 × 10; 4.1 × 10), FBG (= 0.01; 0.021), and HbA1c (= 0.039; 0.018) than those T2D patients without MetS, respectively.
Although there is a low concordance between IDF and revised NCEP ATP III criteria in the diagnosis of MetS among T2D patients, both criteria showed that T2D patients with 5 MetS factors had higher insulin resistance, C-peptide, FBG, and HbA1c.
2型糖尿病（T2D）的慢性并发症，如大血管疾病，会随着代谢综合征（MetS）风险因素数量的增加而加剧。本研究旨在探讨根据国际糖尿病联盟（IDF）或修订后的美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP ATP III）标准诊断的MetS与T2D患者的血糖控制、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、C肽和胰岛素抵抗之间的关系。
本研究为横断面观察性研究，纳入了485名在马来西亚吉隆坡马来西亚国民大学医学中心（UKMMC）接受治疗的T2D患者。根据IDF和修订后的NCEP ATP III标准诊断T2D患者中的MetS。C肽和HbA1c水平分别通过自动定量免疫分析分析仪和高效液相色谱法测定。采用分光光度计测量MetS因素；FBG、甘油三酯和高密度脂蛋白胆固醇。
分别应用IDF和修订后的NCEP ATP III标准，导致73%和85%的T2D受试者被诊断为MetS。这些标准在诊断T2D患者的MetS方面的一致性较低（κ = 0.33，< 0.001）。IDF和修订后的NCEP ATP III标准均表明，与无MetS的T2D患者相比，有5个MetS因素的T2D患者的胰岛素抵抗（= 2.1×10；1.4×10）、C肽（= 1.21×10；4.1×10）、FBG（= 0.01；0.021）和HbA1c（= 0.039；0.018）更高。
尽管IDF和修订后的NCEP ATP III标准在诊断T2D患者的MetS方面一致性较低，但两个标准均表明，有5个MetS因素的T2D患者具有更高的胰岛素抵抗、C肽、FBG和HbA1c。
