OBJECTIVE: To assess the independent and joint effects of the components of the metabolic syndrome, including leptin, which is a recently proposed addition to this syndrome, in predicting the cumulative incidence of impaired glucose tolerance (IGT) and diabetes among individuals with normal glucose tolerance. RESEARCH DESIGN AND METHODS: This prospective study involved 2,605 residents of Mauritius with normal glucose tolerance who were followed for 5 years for IGT or diabetes onset in relation to total and regional adiposity (BMI, waist-to-hip ratio [WHR]), fasting and 2-h 75-g oral glucose load glucose and insulin, total and HDL cholesterol, blood pressure, serum uric acid, triglyceride, and leptin levels. RESULTS: A multivariate logistic regression model adjusted for age, sex, ethnicity, and diabetes family history showed a significantly higher linear increase in risk of IGT and diabetes in association with the following variables only: fasting glucose (odds ratio 1.89 [95% CI 1.51-2.34]), 2-h glucose (1.68 [1.50-1.88]), WHR (1.30 [1.10-1.52]), BMI (1.04 [1.00-1.08]), and serum uric acid (1.37 [1.20-1.57]). However, a nonlinear increase was seen with serum triglyceride and plasma leptin concentrations. No risk factors resulted in joint effects that were greater than expected from combining individual effects. CONCLUSIONS: Metabolic syndrome features independently predict a higher risk of diabetes or IGT in normoglycemic subjects but in combination confer no higher-than-expected risk of these outcomes. At higher concentrations of triglycerides and leptin, risk plateaus and even declines slightly.
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September 01 2000
Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: a prospective study in Mauritius.
E J Boyko;
E J Boyko
International Diabetes Institute, Melbourne, Victoria, Australia. [email protected]
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M de Courten;
M de Courten
International Diabetes Institute, Melbourne, Victoria, Australia. [email protected]
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P Z Zimmet;
P Z Zimmet
International Diabetes Institute, Melbourne, Victoria, Australia. [email protected]
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P Chitson;
P Chitson
International Diabetes Institute, Melbourne, Victoria, Australia. [email protected]
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J Tuomilehto;
J Tuomilehto
International Diabetes Institute, Melbourne, Victoria, Australia. [email protected]
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K G Alberti
K G Alberti
International Diabetes Institute, Melbourne, Victoria, Australia. [email protected]
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Citation
E J Boyko, M de Courten, P Z Zimmet, P Chitson, J Tuomilehto, K G Alberti; Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: a prospective study in Mauritius.. Diabetes Care 1 September 2000; 23 (9): 1242–1248. https://doi.org/10.2337/diacare.23.9.1242
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