Metabolic Syndrome and Prediabetes Identify Overlapping But Not Identical Populations
| Autor: | Georgiopoulos Dx, Sotirios A. Raptis, Emmanuel A. Andreadis, E J Diamantopoulos, G I Tsourous, Ifanti Gk, George Dimitriadis, C V Vassilopoulos, Katsanou Pm |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Gastroenterology Cohort Studies Diagnosis Differential Prediabetic State Impaired glucose tolerance Endocrinology Insulin resistance Diabetes mellitus Internal medicine Internal Medicine medicine Humans Obesity Prediabetes Medical History Taking Aged Metabolic Syndrome business.industry Carotid ultrasonography General Medicine Middle Aged Overweight medicine.disease Impaired fasting glucose Female Metabolic syndrome business Body mass index |
| Zdroj: | Experimental and Clinical Endocrinology & Diabetes. 114:377-383 |
| ISSN: | 1439-3646 0947-7349 |
| DOI: | 10.1055/s-2006-924319 |
| Popis: | OBJECTIVE The metabolic syndrome (MetS) is a cluster of risk factors related to cardiovascular disease. Prediabetes, identified by impaired fasting glucose and/or impaired glucose tolerance, may predict future development of diabetes mellitus. However, it is not clear whether MetS and prediabetes represent the same or different clinical entities. This study compares MetS and prediabetes in terms of cardiovascular risk factors and target organ damage. RESEARCH DESIGN AND METHODS A total of 524 overweight and obese (body mass index, BMI >or= 27 kg/m (2)) adults, mean age 53.6 +/- 10.3 years, 264 men and 260 women, were studied. All participants underwent a thorough clinical and laboratory evaluation, including an oral glucose tolerance test and insulin measurements. Echocardiography, carotid ultrasonography, and pulse wave analysis were also performed for the detection of target organ damage. NCEP-ATP III and ADA criteria were used for the diagnosis of MetS and prediabetes. RESULTS The prevalence of MetS and prediabetes was 38.7 and 25.4 %, respectively. Overall, 129 individuals (24.6 %) had MetS without prediabetes (group M) and another 59 (11.3 %) prediabetes without MetS (group P). Group P had decreased albumin excretion (p = 0.033) and more thickened common carotid intima-media in comparison to group M (p = 0.032). Furthermore, group M was associated with higher C-reactive protein levels. Multiple logistic regression analysis revealed that advanced age (p < 0.0001, OR 1.11, 95 % CI 1.06 - 1.16), low insulin secretion (p < 0.0001, OR 0.05, 95 % CI 0.02 - 0.18 for insulinogenic index), and increased insulin resistance (p = 0.0003, OR 3.22, 95 % CI 1.71 - 6.07 for HOMA-IR) were associated with group P. CONCLUSIONS Our data demonstrate that MetS and prediabetes have an overlapping pattern. MetS appears to have a more pronounced effect on early renal dysfunction and increased inflammatory activation, while prediabetes tends to be associated with early carotid structural changes. These findings may be due to a different pathophysiologic substrate of these clinical phenotypes in terms of insulin resistance and secretion, as well as to the varying prevalence of cardiovascular risk factors. |
| Databáze: | OpenAIRE |
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