Prevalence of metabolic syndrome in type 2 diabetic patients: A comparative study using WHO, NCEP ATP III, IDF and Harmonized definitions

Abstract

To determine the prevalence of metabolic syndrome (MetS) in Malaysian type 2 diabetic patients using WHO, NCEP ATP III, IDF and the new Harmonized definitions, and the concordance between these definitions. This study involved 313 patients diagnosed with type 2 diabetes mellitus (T2DM) at two Malaysian tertiary hospitals. Socio-demographic data were assessed using a pre-tested interviewer-administered structured questionnaire. Anthropometric measurements were carried out according to standard protocols. Clinical and laboratory characteristics were examined. Kappa () statistics were used for the agreement between the four MetS definitions. The overall prevalence rates of MetS (95% CI) were 95.8% (93.6 -98.1), 96.1% (94.0 -98.3), 84.8% (80.8 -88.9) and 97.7% (96.1-99.4) according to the WHO, NCEP ATP III, IDF and the Harmonized definitions, respectively. The Kappa statistics demonstrated a slight to substantial agreement between the definitions ( = 0.179 -0.875, p < 0.001), where the WHO criteria revealed the highest concordance with the NCEP ATP III definition ( = 0.875, p < 0.001). The WHO against NCEP ATP III criteria evinced the highest sensitivity (99.66%) whereas Harmonized criteria against all the other three definitions showed the highest specificity (100%) in identifying MetS. In conclusion, the new Harmonized criteria established the highest prevalence of MetS among the four definitions applied. There was a very good concordance between the WHO and NCEP ATP III criteria. The extremely high prevalence of MetS observed in type 2 diabetic patients indicates an impending pandemic of CVD risk in Malaysia. Aggressive treatment of MetS components is required to reduce cardiovascular risk in T2DM.

Prevalence of Metabolic Syndrome in individuals with Type 2 Diabetes Mellitus

“…This result is similar to that obtained in a study performed in Bangladesh, where the percentage of individuals with altered blood sugar levels was 69% (16) .Regarding the similarity of high AC, the international literature emphasizes that patients with type 2 DM have similar or higher values than those from the study in question (16)(17) . Moreover, Malaysian researchers found that 92.9% of patients with type 2 DM had hypertriglyceridemia, higher than the results found in the present study (8) . The appearance of such imbalance is mainly due to the current inactive lifestyle of the population associated with inadequate eating habits, which generates innumerable cardio-metabolic complications, apart from MS.…”

“…Regarding blood pressure and HDL cholesterol values, more than half of the sample managed to control such variables, although without relevance. However, the blood pressure levels found in study participants were better than those obtained in other studies, where high AP was observed in 90.4% of individuals (7)(8) . It should be noted that one of the main comorbidities associated with diabetes is precisely arterial hypertension, due to the sequence of changes linked to lack of metabolic control in this population.…”

“…Taking these factors into consideration, in recent years, studies have been developed aiming to identify the prevalence of MS in individuals diagnosed with type 2 DM through the NCEP ATP III criterion. Until this moment, the values found vary from 80% to 96.1%, in different regions of the world (7)(8)(9) . In Brazil, a study conducted in Rio Grande do Sul also found a high prevalence of MS in individuals with type 2 DM, totaling 78.6% (10) .…”

Prevalence of metabolic syndrome in Nepalese type 2 diabetic patients according to WHO, NCEP ATP III, IDF and Harmonized criteria

“…This definition was introduced very recently in 2009 to bring the harmony in the several existing definitions of the MetS [ 8 ]. Studies that have used this definition also reported very high prevalence of MetS confirming its improved performance in other diabetic population too [ 29 , 30 ]. Because of the very high cut-off points for waist circumference, NCEP definition could identify relatively low number of patients with central obesity.…”

Prevalence of Metabolic Syndrome among Breast Cancer Survivors in East Coast of Peninsular Malaysia

“…In terms of the agreement between different MetS definition, one of the previous study conducted among Malaysian adult showed that the Harmonized definition exhibited good concordance with WHO and ATP III definitions (Tan et al 2013). However, another study also conducted among Malaysian adults reported better agreement between Harmonized and IDF definitions (Ramli et al 2013).…”