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Metabolic syndrome components and their response to lifestyle and metformin interventions are associated with differences in diabetes risk in persons with impaired glucose tolerance
- Source :
- Diabetes, Obesity and Metabolism. 16:326-333
- Publication Year :
- 2013
- Publisher :
- Wiley, 2013.
-
Abstract
- Aims: To determine the association of metabolic syndrome (MetS) and its components with diabetes risk in participants with impaired glucose tolerance (IGT), and whether intervention-related changes in MetS lead to differences in diabetes incidence. Methods: We used the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) revised MetS definition at baseline and intervention-related changes of its components to predict incident diabetes using Cox models in 3234 Diabetes Prevention Program (DPP) participants with IGT over an average follow-up of 3.2 years. Results: In an intention-to-treat analysis, the demographic-adjusted hazard ratios (95% confidence interval) for diabetes in those with MetS (vs. no MetS) at baseline were 1.7 (1.3–2.3), 1.7 (1.2–2.3) and 2.0 (1.3–3.0) for placebo, metformin and lifestyle groups, respectively. Higher levels of fasting plasma glucose and triglycerides at baseline were independently associated with increased risk of diabetes. Greater waist circumference (WC) was associated with higher risk in placebo and lifestyle groups, but not in the metformin group. In a multivariate model, favourable changes in WC (placebo and lifestyle) and high-density lipoprotein cholesterol (placebo and metformin) contributed to reduced diabetes risk. Conclusions: MetS and some of its components are associated with increased diabetes incidence in persons with IGT in a manner that differed according to DPP intervention. After hyperglycaemia, the most predictive factors for diabetes were baseline hypertriglyceridaemia and both baseline and lifestyle-associated changes in WC. Targeting these cardiometabolic risk factors may help to assess the benefits of interventions
- Subjects :
- Blood Glucose
Male
medicine.medical_specialty
Diabetes risk
Diet, Reducing
Endocrinology, Diabetes and Metabolism
Placebo
Article
Impaired glucose tolerance
Endocrinology
Risk Factors
Diabetes mellitus
Internal medicine
Glucose Intolerance
Internal Medicine
medicine
Humans
Hypoglycemic Agents
Exercise
National Cholesterol Education Program
Triglycerides
Proportional Hazards Models
Metabolic Syndrome
business.industry
Incidence
Remission Induction
Hazard ratio
Age Factors
nutritional and metabolic diseases
Fasting
Middle Aged
medicine.disease
Metformin
Diabetes Mellitus, Type 2
Cardiovascular Diseases
Female
Waist Circumference
Metabolic syndrome
business
Risk Reduction Behavior
Diabetic Angiopathies
medicine.drug
Subjects
Details
- ISSN :
- 14628902
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Diabetes, Obesity and Metabolism
- Accession number :
- edsair.doi.dedup.....cc0512f855d368c813344c43cbb09d33