Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 23, Parvaneh Street, Velenjak, Tehran, P.O. Box: 19395-4763, IR, Iran.
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran.
J Transl Med. 2023 Oct 25;21(1):750. doi: 10.1186/s12967-023-04639-w.
The available evidence indicates that the severity of metabolic syndrome tends to worsen progressively over time. We assessed the trajectory of age and sex-specific continuous MetS severity score (cMetS-S) and its association with the development of diabetes during an 18-year follow-up.
In a prospective population-based Tehran Lipid and Glucose Study, 3931 eligible participants free of diabetes, aged 20-60 years, were followed at three-year intervals. We examined the trajectories of cMetS-S over nine years using latent growth mixture modeling (LGMM) and subsequent risks of incident diabetes eight years later. The prospective association of identified trajectories with diabetes was examined using the Cox proportional hazard model adjusting for age, sex, education, and family history of diabetes, physical activity, obesity (BMI ≥ 30 kg/m), antihypertensive and lipid-lowering medication, and baseline fasting plasma glucose in a stepwise manner.
Among 3931 participants, three cMetS-S trajectory groups of low (24.1%), medium (46.8%), and high (29.1%) were identified during the exposure period. Participants in the medium and high cMetS-S trajectory classes had HRs of 2.44 (95% CI: 1.56-3.81) and 6.81 (95% CI: 4.07-10.01) for future diabetes in fully adjusted models, respectively. Normoglycemic individuals within the high cMetS-S class had an over seven-fold increased risk of diabetes (HR: 7.12; 95% CI: 6.05-12.52).
Although most adults exhibit an unhealthy metabolic score, its severity usually remains stable throughout adulthood over ten years of follow-up. The severity score of metabolic syndrome has the potential to be utilized as a comprehensive and easily measurable indicator of cardiometabolic dysfunction. It can be employed in clinical settings to detect and track individuals at a heightened risk of developing T2DM, even if their glucose levels are normal.
现有证据表明，代谢综合征的严重程度往往随着时间的推移逐渐恶化。我们评估了年龄和性别特异性连续代谢综合征严重程度评分（cMetS-S）的轨迹及其与 18 年随访期间糖尿病发展的关系。
在一项前瞻性的基于人群的德黑兰血脂和血糖研究中，对 3931 名无糖尿病的、年龄在 20-60 岁的合格参与者进行了三年一次的随访。我们使用潜在增长混合模型（LGMM）评估了 cMetS-S 在九年期间的轨迹，并随后评估了八年后新发糖尿病的风险。使用 Cox 比例风险模型，逐步调整年龄、性别、教育程度和糖尿病家族史、体力活动、肥胖（BMI≥30kg/m2）、降压和降脂药物以及基线空腹血糖，检验确定轨迹与糖尿病的前瞻性关联。
在 3931 名参与者中，在暴露期内确定了 cMetS-S 轨迹的三个低（24.1%）、中（46.8%）和高（29.1%）轨迹组。在完全调整模型中，中、高 cMetS-S 轨迹组的 HR 分别为 2.44（95%CI：1.56-3.81）和 6.81（95%CI：4.07-10.01）。高 cMetS-S 组内的血糖正常者患糖尿病的风险增加了七倍以上（HR：7.12；95%CI：6.05-12.52）。
尽管大多数成年人的代谢评分不健康，但在 10 年的随访中，其严重程度通常在整个成年期保持稳定。代谢综合征严重程度评分有可能作为一种全面、易于测量的心血管代谢功能障碍指标。它可以在临床环境中用于检测和跟踪处于 2 型糖尿病风险增加的个体，即使他们的血糖水平正常。
