Comparison of diagnostic criteria and prevalence of metabolic syndrome using WHO, NCEP-ATP III, IDF and harmonized criteria: A case study from urban southeast Nigeria

Uric acid to HDL ratio: A marker for predicting incidence of metabolic syndrome in patients with type II diabetes

BACKGROUND AND AIM

Metabolic syndrome (MetS) refers to existence of a set of risk factors for developing cardiovascular disease and diabetes. Recently, uric acid to HDL ratio has attracted attention in predicting development of diabetes and incidence of metabolic syndrome in diabetic individuals. This study was performed to investigate UHR in patients with type II diabetes as a predicting factor for metabolic syndrome.

METHODS AND RESULTS

This descriptive-analytical study examined 300 patients with type II diabetes referring to diabetes clinic of Ali-Ibn Abi-Talib hospital, Rafsanjan city in 2021, selected through convenient sampling. Data were collected by a research-made checklist (including demographic, clinical and laboratory parameters) and analyzed by SPSS 24 and chi-square, Fisher exact test, independent paired t-test, one-way analysis of variance (ANOVA), Mann-Whitney U, and receiver operating characteristic (ROC). The findings revealed that 74.33 % (95 % CI: 69 to 79.18 %) of the patients had metabolic syndrome. Further, patients with metabolic syndrome demonstrated a significantly higher mean UHR ratio and triglyceride levels compared to their counterparts without the syndrome (p = 0.002 and p < 0.001, respectively). The ROC analysis identified a UHR threshold of 8.118 % with a sensitivity of 70.32 % and specificity of 55.08 % for diagnosing metabolic syndrome development in type II diabetes (AUC: 0.621, P = 0.001, 95%CI: 0.549-0.694).

CONCLUSION

The results of the present study revealed that the prevalence of metabolic syndrome was high in diabetic patients. UHR showed good sensitivity in the diagnosis of metabolic syndrome in type II diabetes. Thus, regular monitoring of laboratory tests is recommended in patients with diabetes.

Prevalence and correlates of metabolic syndrome among adults in freetown, Sierra Leone: A comparative analysis of NCEP ATP III, IDF and harmonized ATP III criteria

Background

Metabolic syndrome (MetS) is a global health concern, especially for low and middle-income countries with limited resources and information. The study's objective was to assess the prevalence of MetS in Freetown, Sierra Leone, using the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), International Diabetes Federation (IDF) and Harmonize ATP III. Additionally, we aimed to establish the concordance between these three different criteria used.

Methods

This community-based health screening survey was conducted from October 2019 to October 2022. A multistage stratified random design was used to select adults aged 20 years and above. Mean, interquartile range (IQR), and logistic regression were used for statistical analysis. The kappa coefficient statistics resolved the agreement between these defined criteria.

Results

The prevalence for NCEP ATP III, Harmonize ATP III and IDF criteria was 11.8 % (95 % CI: 9.0-15.15), 14.3 % (95 % CI: 11.3-18.0), and 8.5 % (95 % CI: 6.2-11.2), respectively for the 2394 selected adults. The kappa coefficient (κ) agreement between the MetS is: Harmonized ATP III and IDF criteria = [(208 (60.8 %); (κ = 0.62)]; Harmonized ATP III and NCEP ATP III = [(201 (58.7 %); (κ = 0.71)]; while IDF and NCEP ATP III was [(132 (38.6 %); (κ = 0.52)]. In the multivariable regression analysis, waist circumference correlated with all three MetS criteria: ATP III [AOR = 0.85; C.I 95 %: (0.40-1.78), p = 0.032], Harmonized ATP III [AOR = 1.14; C.I 95 %: (0.62-2.11), p = 0.024], IDF [AOR = 1.06; C.I 95 % (0.52-2.16), p = 0.018].

Conclusion

We reported a high prevalence of MetS in Freetown, Sierra Leone and identified waist circumference as a major risk factor for MetS. This underscores the crucial role of health education and effective management of MetS in Sierra Leone.

Double diabetes-when type 1 diabetes meets type 2 diabetes: definition, pathogenesis and recognition

Currently, the differentiation between type 1 diabetes (T1D) and type 2 diabetes (T2D) is not straightforward, and the features of both types of diabetes coexist in one subject. This situation triggered the need to discriminate so-called double diabetes (DD), hybrid diabetes or type 1.5 diabetes, which is generally described as the presence of the insulin resistance characteristic of metabolic syndrome in individuals diagnosed with T1D. DD not only raises the question of proper classification of diabetes but is also associated with a significantly greater risk of developing micro- and macroangiopathic complications, which was independent of glycaemic control. When considering the global obesity pandemic and increasing incidence of T1D, the prevalence of DD may also presumably increase. Therefore, it is of the highest priority to discover the mechanisms underlying the development of DD and to identify appropriate methods to prevent or treat DD. In this article, we describe how the definition of double diabetes has changed over the years and how it is currently defined. We discuss the accuracy of including metabolic syndrome in the DD definition. We also present possible hypotheses connecting insulin resistance with T1D and propose possible methods to identify individuals with double diabetes based on indirect insulin resistance markers, which are easily assessed in everyday clinical practice. Moreover, we discuss adjuvant therapy which may be considered in double diabetic patients.

Critical assessment of the metabolic syndrome definitions in the adult general population of the United States - the Multi-Ethnic Study of Atherosclerosis (MESA)

Background

Metabolic syndrome (MetS) consists of a cluster of cardiometabolic risk factors and is an important determining factor for cardiovascular diseases (CVDs). We intended to use latent class analysis to classify the study population into several clusters.

Methods

The baseline information of 6,814 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) aged 45-84 years in 2000-2002 was used. The latent class analysis was conducted to extract different patterns of components. SAS 9.2 and Stata 12 software were used for analysis.

Results

The components of MetS tend to accumulate, hence it would be feasible to categorize the population into three classes: [1] Non-Metabolic Syndrome Latent Class (NonMetS-LC), [2] Low Risk Latent Class (LowR-LC), and [3] Metabolic Syndrome Latent Class (MetS-LC). In women, adding high-density lipoprotein (HDL) component to the two-component combinations of NonMetS-LC will transfer the individual to MetS-LC, and it was found in 100% of combinations of MetS-LC. However, in men, blood pressure (BP) played such a similar role, which was found in 97.36% of combinations of MetS-LC.

Conclusion

Results showed that clinical value of each MetS component is different by gender. The main component in men was elevated BP; while low HDL and elevated fasting blood sugar (FBS) were in next ranks. However, the main component in women was low HDL; while elevated BP and FBS were in next ranks. Special attention should be paid to BP and HDL components, because these can be useful for clinicians and health policy-makers in diagnosis and screening. In conclusion, this study showed that revisions might be needed for the MetS definitions.

Graphical abstract