Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: A prospective study in Mauritius

E. J. Boyko, M. De Courten, P. Z. Zimmet, P. Chitson, J. Tuomilehto, K. G.M.M. Alberti

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Abstract

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.

Original languageEnglish
Pages (from-to)1242-1248
Number of pages7
JournalDiabetes Care
Volume23
Issue number9
DOIs
Publication statusPublished - 1 Jan 2000
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Boyko, E. J., De Courten, M., Zimmet, P. Z., Chitson, P., Tuomilehto, J., & Alberti, K. G. M. M. (2000). Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: A prospective study in Mauritius. Diabetes Care, 23(9), 1242-1248. https://doi.org/10.2337/diacare.23.9.1242