Metabolic syndrome in north Indian type 2 diabetes mellitus patients: A comparison of four different diagnostic criteria of metabolic syndrome

Identifying metabolic syndrome in migrant Asian Indian adults with anthropometric and visceral fat action points

BACKGROUND

Metabolic syndrome (MetS) is a clustering of metabolic risk factors, including large waist circumference (WC). Other anthropometric parameters and visceral fat mass (VFM) predicted from these may improve MetS detection. Our aim was to assess the ability of such parameters to predict this clustering in a cross-sectional, diagnostic study.

METHOD

Participants were 82 males and 86 females, aged 20-74 years, of Asian Indian ethnicity. VFM was estimated by dual-energy X-ray absorptiometry (DXA) through identification of abdominal subcutaneous fat layer boundaries. Non-anthropometric metabolic risk factors (triglycerides, HDL cholesterol, blood pressure and glucose) were defined using MetS criteria. We estimated the ability of anthropometry and VFM to detect ≥ 2 of these factors by receiver operating characteristic (ROC) and precision-recall curves.

RESULTS

Two or more non-anthropometric metabolic risk factors were present in 45 (55%) males and 29 (34%) females. The area under the ROC curve (AUC) to predict ≥ 2 of these factors using WC was 0.67 (95% confidence interval: 0.55-0.79) in males and 0.65 (0.53-0.77) in females. Optimal WC cut-points were 92 cm for males (63% accuracy) and 79 cm for females (53% accuracy). VFM, DXA-measured sagittal diameter and suprailiac skinfold thickness yielded higher AUC point estimates (by up to 0.06), especially in females where these measures improved accuracy to 69%, 69% and 65%, respectively. Pairwise combinations that included WC further improved accuracy.

CONCLUSION

Our findings indicate that cut-points for readily obtained measures other than WC, or in combination with WC, may provide improved detection of MetS risk factor clusters.

A Comparative Assessment of Metabolic Syndrome and its Association with Vitamin D and Other Risk Factors in Type 2 Diabetes Mellitus Patients

OBJECTIVES

To determine the overall prevalence of metabolic syndrome using the World Health Organization (WHO); National Cholesterol Education Program (NCEP), and the International Diabetes Federation (IDF) guidelines and to study its association with vitamin D and other biochemical parameters in patients with type 2 Diabetes mellitus, as well as to identify the set of biochemical parameters that jointly influence the metabolic syndrome using different diagnostic criteria.

METHODS

A cross-sectional study was carried out at a private health care center in -a total of 291 diabetic patients. Socio-demographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS, version 23).

RESULTS

A total number of 291 patients with T2DM were included in this study. The overall prevalence of metabolic syndrome among the study subjects was 48.1%, 87.3%, 64.9% using the WHO, IDF, and NCEP-ATPIII criteria, respectively. The highest prevalence was reported following IDF diagnostic criteria. Sex, triglyceride, and fasting blood sugar were associated factors of metabolic syndrome by all the three diagnostic criteria of metabolic syndrome.

CONCLUSION

The study revealed a high prevalence rate of metabolic syndrome among type 2 diabetic patients, which was highest at 87.3% according to IDF and lowest was observed according to the WHO criteria i.e, 48.1%. A significant variance in the prevalence of metabolic syndrome was reported between WHO, IDF, and NCEP criteria.