A Test to Predict Diabetes Risk

Metabolic syndrome also warns of heart disease, study finds

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By
HealthDay Reporter

(HealthDay is the new name for HealthScoutNews.)

MONDAY, July 14, 2003 (HealthDayNews) -- A cluster of cardiovascular risk factors known as metabolic syndrome can warn of impending diabetes as well as heart disease, a new Scottish study finds.

"This is the first prospective study to show that the new criteria for the metabolic syndrome can predict excess risk for both coronary heart disease and diabetes," says study author Dr. Naveed Sattar, an honorary consultant in clinical biochemistry at the Glasgow Royal Infirmary.

The report appears in the July 15 issue of Circulation.

Someone with three of the five following risk factors would be considered to have metabolic syndrome:

  • Obesity, defined as a waistline of at least 40 inches for men, 30 inches for women.
  • High blood triglycerides, 150 milligrams per deciliter or greater.
  • Low HDL cholesterol, the "good" kind, under 40 milligrams per deciliter for men, 50 for women.
  • High blood pressure, 130/85 or greater.
  • High fasting blood glucose (sugar) levels, 110 milligrams per deciliter or greater.

Of the 6,447 men in the West of Scotland Coronary Prevention Study, those with three risk factors were 1.7 times more likely to develop serious heart disease and 3.5 times more likely to develop diabetes during a 4.9-year follow-up.

The risk increased with the number of abnormalities. Men with four or five risk factors were 3.7 times more likely to develop heart disease and nearly 25 times more likely to develop diabetes during that time.

The Scottish researchers did use a different measure of obesity, the Body Mass Index -- weight in kilograms divided by height in meters squared. And, as Sattar notes, they used a relatively new revision of metabolic syndrome that catches disease development at an earlier stage.

Detecting people with metabolic syndrome "lends itself to lifestyle modification," Sattar says, but he thinks more work is needed -- for example, to determine whether specific factors provide a better determinant of risk.

Looking at the report with a critical eye, Dr. Sidney Smith, a professor of medicine at the University of North Carolina and spokesman for the American Heart Association, picks out some points of note.

For example, measures of HDL cholesterol were not important in predicting risk, he says. And adding another element, blood levels of C-reactive protein, which is involved in inflammation, improved the predictive power substantially. Overall, Smith says, it's "an important paper" that allows early intervention to prevent heart disease and diabetes.

"We're just getting to the point where we can understand how to wrestle with this epidemic of diabetes," Smith says. He sees the bulging waistline as increasingly important because "obesity is a growing problem in our society."

Just cutting back on overall calorie and fat intake isn't enough, he says, because "substituting a lot of carbohydrates for fat is not an appropriate way to approach concerns about a high-fat diet. A diet that is balanced, low in fat and rich in vegetables, fruits and bread grains is an effective measure."

More information

A complete rundown on metabolic syndrome is given by the American Heart Association or ABCNews.com.

SOURCES: Naveed Sattar, M.D., reader, endocrinology and metabolism, Glasgow Royal Infirmary, Scotland; Sidney Smith, M.D., professor, medicine, University of North Carolina, Charlotte; July 15, 2003, Circulation

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