Diabetes Metab J.  2019 Aug;43(4):530-538. 10.4093/dmj.2018.0111.

Impact of Longitudinal Changes in Metabolic Syndrome Status over 2 Years on 10-Year Incident Diabetes Mellitus

• Huh JH
• Ahn SG
• Kim YI
• Go T
• Sung KC
• Choi JH
• Koh KK
• Kim JY

• KMID: 2455675
• DOI: http://doi.org/10.4093/dmj.2018.0111

Abstract

BACKGROUND
Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM.
METHODS
We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models.
RESULTS
During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group (P for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later.
CONCLUSION
We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.

Keyword

Diabetes mellitus; Life style; Metabolic syndrome

MeSH Terms

Diabetes Mellitus*
Epidemiology
Follow-Up Studies
Genome
Life Style
Proportional Hazards Models

Figure

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  Fig. 1 Flow chart. OGTT, oral glucose tolerance test; MetS, metabolic syndrome.

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  Fig. 2 Diabetes-free survival duration according to change in metabolic syndrome (MetS) status from baseline to 2 years by Kaplan-Meier analysis.

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  Fig. 3 Adjusted hazard ratio (HR) for incident diabetes according to changes in number of metabolic syndrome component for 2 years follow-up. The data shown are from cubic splines and the 95% confidence intervals. Adjusted HRs are from Cox proportional-hazards models after adjusting for age, sex, family history of diabetes, smoking, alcohol intake, regular exercise, energy intake, body mass index, alanine aminotransferases, and post-load glucose at baseline.

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