Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
BMJ Open. 2024 Sep 10;14(9):e078701. doi: 10.1136/bmjopen-2023-078701.
This study aimed to investigate the association between age-specific and sex-specific continuous metabolic syndrome severity score (cMetS-S) and the risk of developing type 2 diabetes mellitus (T2DM). Additionally, the study aimed to assess the added value of cMetS-S in predicting T2DM compared with traditional MetS criteria.
The study used a longitudinal cohort design, following participants for 18 years.
The research was conducted within the Tehran Lipid and Glucose Study, a community-based study in Tehran, Iran.
A total of 6957 participants aged 20-60 years were included in the study.
INTERVENTIONS/EXPOSURES: The cMetS-S of each participant was determined using age-specific and sex-specific equations and Cox proportional hazard regression models were used to analyse the association between cMetS-S and T2DM using continuous and quantile approaches.
The outcome measure was the association between cMetS-S and the development of T2DM during the 18-year follow-up.
A total of 1124 T2DM cases were recorded over 18 years of follow-up. In the fully adjusted model, a 1-SD increase in the cMetS-S was associated with future T2DM (HR 1.72; 95% CI 1.54 to 1.91). Men and women had HRs of 1.65 (95% CI 1.40 to 1.95) and 1.83 (95% CI 1.59 to 2.10) for T2DM per 1-SD increase in cMetS-S, respectively. Higher cMetS-S was associated with increased risk of diabetes in both prediabetic (HR 1.42;95% CI 1.23 to 1.64) and normoglycaemic individuals (HR 2.11;95% CI 1.76 to 2.54); this association was more significant in normoglycaemic individuals. Unlike the traditional-based MetS definitions, the cMetS-S improved diabetes prediction (p<0.001).
The cMetS-S is strongly associated with future diabetes in prediabetic and normoglycaemic individuals independent of MetS components during a long term. As the relationship between cMetS-S and T2DM is more pronounced in normoglycaemic individuals than in those with pre-diabetes, implementing the evaluation of cMetS-S can serve as an early identification tool for individuals at risk of T2DM prior to the onset of pre-diabetes.
本研究旨在探讨特定年龄段和性别连续代谢综合征严重程度评分（cMetS-S）与 2 型糖尿病（T2DM）发病风险之间的关系。此外，本研究旨在评估 cMetS-S 在预测 T2DM 方面相较于传统代谢综合征标准的附加价值。
本研究采用纵向队列设计，对参与者进行了 18 年的随访。
研究在伊朗德黑兰的一项基于社区的 Tehran Lipid and Glucose Study 中进行。
共有 6957 名年龄在 20-60 岁的参与者纳入研究。
干预/暴露因素：使用特定年龄段和性别的方程确定每位参与者的 cMetS-S，使用 Cox 比例风险回归模型通过连续和分位数方法分析 cMetS-S 与 T2DM 之间的关联。
结局测量为 cMetS-S 与 18 年随访期间 T2DM 发病之间的关系。
在 18 年的随访中，共记录了 1124 例 T2DM 病例。在完全调整模型中，cMetS-S 每增加 1 个标准差，未来发生 T2DM 的风险就会增加（HR 1.72；95%CI 1.54 至 1.91）。男性和女性的 HR 分别为 1.65（95%CI 1.40 至 1.95）和 1.83（95%CI 1.59 至 2.10）。对于每增加 1 个标准差的 cMetS-S，无论糖尿病前期还是血糖正常的个体，T2DM 的发生风险均增加（HR 1.42；95%CI 1.23 至 1.64）和（HR 2.11；95%CI 1.76 至 2.54）；在血糖正常的个体中，这种关联更为显著。与基于传统的代谢综合征定义不同，cMetS-S 改善了糖尿病的预测（p<0.001）。
cMetS-S 与糖尿病前期和血糖正常个体的未来糖尿病密切相关，这与长期代谢综合征成分无关。由于 cMetS-S 与 T2DM 之间的关系在血糖正常个体中比在糖尿病前期个体中更为明显，因此在糖尿病前期发生之前，评估 cMetS-S 可以作为识别 T2DM 高危个体的早期工具。
