Diagnosing metabolic syndrome in type 2 diabetes: Does it matter?

Abstract

Background: Metabolic syndrome (MetS) is used as a clinical tool to identify individuals at risk of cardiovascular disease (CVD) but its clinical value in the management of type 2 diabetes mellitus (T2DM) remains uncertain. Aim: To determine the prevalence and clinical usefulness of MetS among patients with T2DM attending diabetes clinics in a large teaching hospital. Design: Prospective observational study. Methods: Prevalence of MetS was determined by using International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) definitions in relation to age, sex, diabetes duration and history of CVD. Results: A total of 390 patients were included in this study. Both IDF and NCEP-ATPIII definitions identified high prevalence of MetS in male and female patients (IDF: male vs. female, 91.7 vs. 94.8% and NCEP-ATPIII: male vs. female, 87.6 vs. 94.2%) regardless of age (below vs. above 40 yrs, ∼70-75 vs. ∼90-95% with both definitions), diabetes duration (below vs. above 5 yrs, ∼85-90 vs. 90-95% with both definitions) and history of CVD (without vs. with CVD, ∼90 vs. ∼95% with both definitions). Central obesity was common reflected by mean waist circumference of ∼113 cm regardless of age and gender. Among those who did not have IDF-defined MetS, ∼60% had at least two CVD risk factors. Both definitions similarly classified ∼94% of the patients as either having or not having MetS. Discussion: Both definitions can be used interchangeably to diagnose MetS. However, the clinical usefulness of MetS is debatable given the very high prevalence of this condition in T2DM. © The Author 2008. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.