The Metabolic Syndrome as Predictor of Type 2 Diabetes: The San Antonio Heart Study

Carlos Lorenzo, Mayor Okoloise, Ken Williams, Michael P. Stern, Steven M. Haffner

Research output: Contribution to journalArticle

623 Citations (Scopus)

Abstract

OBJECTIVE - The oral glucose tolerance test identifies high-risk subjects for diabetes, but it is costly and inconvenient. To find better predictors of type 2 diabetes, we evaluated two different definitions of the metabolic syndrome because insulin resistance, which is commonly associated with this clustering of metabolic factors, frequently precedes the onset of type 2 diabetes. RESEARCH DESIGN AND METHODS - We compared the ability, of the National Cholesterol Education Program (NCEP) definition, a modified version of the 1999 World Health Organization (WHO) definition that excludes the 2-h glucose requirement, and impaired glucose tolerance (IGT) to predict incident type 2 diabetes. In the San Antonio Heart Study, 1,734 participants completed a 7- to 8-year follow-up examination. RESULTS - IGT and the NCEP definition had higher sensitivity than the modified WHO definition (51.9, 52.8, and 42.8%, respectively). IGT had a higher positive predictive value than the NCEP and modified WHO definitions (43.0, 30.8, and 30.4%, respectively). The combination of the IGT and NCEP definitions increased the sensitivity to 70.8% with an acceptable positive predictive value of 29.7%. Risk for incidence of type 2 diabetes using the NCEP definition was independent of other risk factors, including IGT and fasting insulin (odds ratio 3.30, 95% CI 2.27-4.80). The NCEP definition performed better with fasting glucose ≥5.4 mmol/l (sensitivity 62.0% and positive predictive value 30.9%). CONCLUSIONS - The metabolic syndrome predicts diabetes independently of other factors. However, the NCEP definition performs better than the modified 1999 WHO definition. Lowering the fasting glucose cutoff to 5.4 mmol/l improves the prediction of diabetes by the metabolic syndrome.

Original languageEnglish (US)
Pages (from-to)3153-3159
Number of pages7
JournalDiabetes Care
Volume26
Issue number11
DOIs
StatePublished - Nov 2003

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Type 2 Diabetes Mellitus
Glucose Intolerance
Cholesterol
Education
Fasting
Glucose
Aptitude
Glucose Tolerance Test
Cluster Analysis
Insulin Resistance
Research Design
Odds Ratio
Insulin
Incidence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Lorenzo, C., Okoloise, M., Williams, K., Stern, M. P., & Haffner, S. M. (2003). The Metabolic Syndrome as Predictor of Type 2 Diabetes: The San Antonio Heart Study. Diabetes Care, 26(11), 3153-3159. https://doi.org/10.2337/diacare.26.11.3153

The Metabolic Syndrome as Predictor of Type 2 Diabetes : The San Antonio Heart Study. / Lorenzo, Carlos; Okoloise, Mayor; Williams, Ken; Stern, Michael P.; Haffner, Steven M.

In: Diabetes Care, Vol. 26, No. 11, 11.2003, p. 3153-3159.

Research output: Contribution to journalArticle

Lorenzo, C, Okoloise, M, Williams, K, Stern, MP & Haffner, SM 2003, 'The Metabolic Syndrome as Predictor of Type 2 Diabetes: The San Antonio Heart Study', Diabetes Care, vol. 26, no. 11, pp. 3153-3159. https://doi.org/10.2337/diacare.26.11.3153
Lorenzo, Carlos ; Okoloise, Mayor ; Williams, Ken ; Stern, Michael P. ; Haffner, Steven M. / The Metabolic Syndrome as Predictor of Type 2 Diabetes : The San Antonio Heart Study. In: Diabetes Care. 2003 ; Vol. 26, No. 11. pp. 3153-3159.
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