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

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.

Exposure-weighted scoring for metabolic syndrome and the risk of myocardial infarction and stroke: a nationwide population-based study

“…In our study, among those who had been ever diagnosed with MetS during the study period, only one-fifth exhibited persistent MetS over the 4 years. This finding supports the notion of dynamic change in MetS over time, as demonstrated in previous studies [14,16,24]. From this perspective, it is important to assess the effects of the accumulation of metabolic risk factors on CVD.…”

“…Similar findings have been observed for other metabolic or vascular diseases. For example, previous studies have reported that changes in MetS status over 2 years are closely associated with the development of diabetes mellitus or chronic kidney disease after 10 years [16,24]. Taken together, these findings suggest that, given the dynamic nature of MetS, a single assessment of MetS may not be sufficient for evaluating its clinical impact.…”

“…From the viewpoint of prevention, MetS and its components can change dynamically over time and are modifiable risk factors for CVD and metabolic diseases. Changes in MetS status or its components differentially affect the risk of CVD and diabetes mellitus [14][15][16][17]. However, beyond simple changes in metabolic health status, the extent and duration of exposure to risk factors may be important to the development of CVD.…”

Hospitalization for heart failure incidence according to the transition in metabolic health and obesity status: a nationwide population-based study

“…In particular, with regard to the risk of HF, Voulgari et al [14] reported that MHO is associated with a lower risk of HF than is MUNO. However, these obesity subphenotypes defined by the status of metabolic health and obesity change dynamically over time [10,[15][16][17][18][19]. Soriguer et al [18] reported that 41.9% of MHO individuals became metabolically unhealthy during the 6-year follow-up, suggesting that obesity sub-phenotypes should account for the passage of time.…”

Changes in Metabolic Profile Over Time: Impact on the Risk of Diabetes

“…In the article entitled “Impact of longitudinal changes in metabolic syndrome status over 2 years on 10-year incident diabetes mellitus,” Huh et al [3] examined whether changes in MetS status over 2 years can modify future risk of diabetes using a prospective cohort of 7,317 participants. They were divided into four groups, two without changes (non-MetS, persistent MetS) and two with changes (resolved MetS, incident MetS).…”