Exp Clin Endocrinol Diabetes 2006; 114(7): 377-383
DOI: 10.1055/s-2006-924319
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Metabolic Syndrome and Prediabetes Identify Overlapping But Not Identical Populations

E. J. Diamantopoulos1 , E. A. Andreadis1 , G. I. Tsourous1 , G. K. Ifanti1 , P. M. Katsanou1 , D. X. Georgiopoulos1 , C. V. Vassilopoulos1 , G. Dimitriadis2 , S. A. Raptis2
  • 14th Department of Internal Medicine and Unit for Vascular Medicine, Evangelismos State General Hospital, Athens, Greece
  • 22nd Department of Internal Medicine, Research Institute and Diabetes Centre, University General Hospital Attikon, Athens, Greece
Further Information

Publication History

Received: August 12, 2005 First decision: March 7, 2006

Accepted: May 29, 2006

Publication Date:
16 August 2006 (online)

Abstract

Objective: The metabolic syndrome (MetS) is a cluster of risk factors related to cardiovascular disease. Prediabetes, identified by impaired fasting glucose and/or impaired glucose tolerance, may predict future development of diabetes mellitus. However, it is not clear whether MetS and prediabetes represent the same or different clinical entities. This study compares MetS and prediabetes in terms of cardiovascular risk factors and target organ damage. Research Design and Methods: A total of 524 overweight and obese (body mass index, BMI ≥ 27 kg/m2) adults, mean age 53.6 ± 10.3 years, 264 men and 260 women, were studied. All participants underwent a thorough clinical and laboratory evaluation, including an oral glucose tolerance test and insulin measurements. Echocardiography, carotid ultrasonography, and pulse wave analysis were also performed for the detection of target organ damage. NCEP‐ATP III and ADA criteria were used for the diagnosis of MetS and prediabetes. Results: The prevalence of MetS and prediabetes was 38.7 and 25.4 %, respectively. Overall, 129 individuals (24.6 %) had MetS without prediabetes (group M) and another 59 (11.3 %) prediabetes without MetS (group P). Group P had decreased albumin excretion (p = 0.033) and more thickened common carotid intima-media in comparison to group M (p = 0.032). Furthermore, group M was associated with higher C-reactive protein levels. Multiple logistic regression analysis revealed that advanced age (p < 0.0001, OR 1.11, 95 % CI 1.06 - 1.16), low insulin secretion (p < 0.0001, OR 0.05, 95 % CI 0.02 - 0.18 for insulinogenic index), and increased insulin resistance (p = 0.0003, OR 3.22, 95 % CI 1.71 - 6.07 for HOMA‐IR) were associated with group P. Conclusions: Our data demonstrate that MetS and prediabetes have an overlapping pattern. MetS appears to have a more pronounced effect on early renal dysfunction and increased inflammatory activation, while prediabetes tends to be associated with early carotid structural changes. These findings may be due to a different pathophysiologic substrate of these clinical phenotypes in terms of insulin resistance and secretion, as well as to the varying prevalence of cardiovascular risk factors.

References

Prof. Dr. med. Emmanuel J. Diamantopoulos

10 Oitis Street

154 52 Paleo Psychiko

Athens

Greece

Phone: + 302107258862 or 2107201529

Fax: + 30 21 07 25 88 62

Email: Dpathologiki@evaggelismos-hosp.gr