Clinical Applicability of the Definition for Metabolic Syndrome of the International Diabetes Federation in Type 2 Diabetic Patients

Author: P. Kamenova

Abstract: 

Bearing in mind the urgent need for single and universally accepted in clinical practice diagnostic criteria for metabolic syndrome the International Diabetes Federation (IDF) proposed a new definition that makes central obesity a necessary requirement and, for the first time, provided different obesity cut-off points for different ethnic groups.

 

The aim of the present cross-sectional study was to characterize metabolic syndrome according to the definition of IDF in representative sample of type 2 diabetic patients. 63 patients (34 females, 29 males) with the following parameters – age 52,0±8,7yrs, BMI 31,5±6,3 kg/m2, waist-tohip ratio 0,90±0,08, waist circumference 101,8±14,7 cm, systolic blood pressure 148±27 mmHg, diastolic blood pressure 96±16 mmHg, triglycerides 2,11±1,31 mmol/l, HDL cholesterol 1,11±0,44 mmol/l (mean±SD) took part in the study. The metabolic syndrome was defined by the required component waist circumference ≥ 80 cm for females and ≥ 94 cm for males and the presence of two more of the following: raised triglycerides ≥ 1,7 mmol/l, reduced HDL cholesterol < 1,29 for females and < 1,03 mmol/l for males, raised blood pressure ≥ 130/ 85 mmHg and previously diagnosed type 2 diabetes. The insulin sensitivity was determined by the gold standard – manual hyperinsulinaemic euglycaemic clamp technique, expressed as a glucose disposal rate (M) and homeostasis model assessment (HOMA-IR).

 

Metabolic syndrome was diagnosed in 51 patients (80,9 %)-30 females (88,2 %) and 21 males (72,4 %). 19 patients (37,2%) were with 4 components of the metabolic syndrome, 18 (35,3 %)-with 3 and 14 (27,5 %) with 5 components of the metabolic syndrome. The highest percent of the patients (72,5 %) were characterized by raised blood pressure, followed by those with raised triglycerides (58,8 %) and reduced HDL cholesterol (56,9 %). Combined dyslipidaemia (high triglycerides and low HDL cholesterol) was established in 31,4 % of the patients. The commonest component of the metabolic syndrome in female sex was raised blood pressure (80 %), and in male sex – reduced HDL cholesterol (76,2 %). Insulin sensitivity of the patients with metabolic syndrome (M) 3,238±1,673 mg/kg/min was significantly lower than that of the patients with no metabolic syndrome-M 6,893±3,846 mg/kg/min, p<0,001. HOMA-IR of the patients with metabolic syndrome 5,89±3,60 was significantly higher than that of the patients with no metabolic syndrome 2,36±1,55, p<0,01.

 

In conclusion, presented data about the incidence of the metabolic syndrome in this representative sample type 2 diabetic patients, according to the criteria of IDF, are similar to previously published in the same sample, applying criteria of WHO. There is some difference in components characteristics between the two definitions.

 

The components of the definition of IDF are easily measurable and accessible that makes it an useful diagnostic tool for metabolic syndrome in patients with type 2 diabetes mellitus.

 

Download the full issue 3/2006