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Diagnosing metabolic syndrome in type 2 diabetes: does it matter?
BACKGROUND: Metabolic syndrome (MetS) is used as a clinical tool to identify individuals at risk of cardiovascular disease (CVD) but its clinical value in the management of type 2 diabetes mellitus (T2DM) remains uncertain.
AIM: To determine the prevalence and clinical usefulness of MetS among patients with T2DM attending diabetes clinics in a large teaching hospital.
DESIGN: Prospective observational study.
METHODS: Prevalence of MetS was determined by using International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) definitions in relation to age, sex, diabetes duration and history of CVD.
RESULTS: A total of 390 patients were included in this study. Both IDF and NCEP-ATPIII definitions identified high prevalence of MetS in male and female patients (IDF: male vs. female, 91.7 vs. 94.8% and NCEP-ATPIII: male vs. female, 87.6 vs. 94.2%) regardless of age (below vs. above 40 yrs, approximately 70-75 vs. approximately 90-95% with both definitions), diabetes duration (below vs. above 5 yrs, approximately 85-90 vs. 90-95% with both definitions) and history of CVD (without vs. with CVD, approximately 90 vs. approximately 95% with both definitions). Central obesity was common reflected by mean waist circumference of approximately 113 cm regardless of age and gender. Among those who did not have IDF-defined MetS, approximately 60% had at least two CVD risk factors. Both definitions similarly classified approximately 94% of the patients as either having or not having MetS.
DISCUSSION: Both definitions can be used interchangeably to diagnose MetS. However, the clinical usefulness of MetS is debatable given the very high prevalence of this condition in T2DM.
AIM: To determine the prevalence and clinical usefulness of MetS among patients with T2DM attending diabetes clinics in a large teaching hospital.
DESIGN: Prospective observational study.
METHODS: Prevalence of MetS was determined by using International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) definitions in relation to age, sex, diabetes duration and history of CVD.
RESULTS: A total of 390 patients were included in this study. Both IDF and NCEP-ATPIII definitions identified high prevalence of MetS in male and female patients (IDF: male vs. female, 91.7 vs. 94.8% and NCEP-ATPIII: male vs. female, 87.6 vs. 94.2%) regardless of age (below vs. above 40 yrs, approximately 70-75 vs. approximately 90-95% with both definitions), diabetes duration (below vs. above 5 yrs, approximately 85-90 vs. 90-95% with both definitions) and history of CVD (without vs. with CVD, approximately 90 vs. approximately 95% with both definitions). Central obesity was common reflected by mean waist circumference of approximately 113 cm regardless of age and gender. Among those who did not have IDF-defined MetS, approximately 60% had at least two CVD risk factors. Both definitions similarly classified approximately 94% of the patients as either having or not having MetS.
DISCUSSION: Both definitions can be used interchangeably to diagnose MetS. However, the clinical usefulness of MetS is debatable given the very high prevalence of this condition in T2DM.
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