Metabolic syndrome among adults with type 2 diabetes in a Saudi teaching hospital: A comparative prevalence study using WHO and ATP III definitions

Abstract

Objective: Metabolic syndrome (MetS) has become a global health concern and is a reliable predictor of long-term adverse health outcomes. This study aimed to determine the prevalence of MetS and its components in a group of Saudi adults with type 2 diabetes using the World Health Organization (WHO) and Adult Treatment Panel (ATP) III definitions, and to examine agreement between both definitions.
 Methods: This cross-sectional study included adults with type 2 diabetes who were followed up at the family medicine and endocrinology clinics of King Abdulaziz University Hospital (KAUH) from January to March 2018. An interview-administered questionnaire was designed to collect demographic data, anthropometric measurements, and medical history. We used the 1999 WHO and 2001 ATP III definitions for diagnosing MetS.
 Results: The study included 155 diabetes patients. The overall prevalence of MetS components (three of more components) among patients was 80% according to the WHO criteria and 85.8% according to the ATP III criteria. The kappa statistics demonstrated good agreement between both definitions (κ = 0.751, p < 0.001). The sensitivity and specificity of diagnosing MetS using the WHO versus ATP III criteria were 92.5% and 95.5%, respectively. There was weak positive association between the number of MetS components and the number of diabetic complications.
 Conclusions: MetS was highly prevalent among Saudi adults with type 2 diabetes regardless of the diagnostic criteria. It is, therefore, imperative that clinicians identify MetS in this patient population and educate them on the importance of adherence to treatment and therapeutic lifestyle changes.
 doi: https://doi.org/10.12669/pjms.35.4.199
 How to cite this:Ghamri RA, Alamri SH. Metabolic syndrome among adults with type 2 diabetes in a Saudi teaching hospital: A comparative prevalence study using WHO and ATP III definitions. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.199
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

<p>Body Composition and the Components of Metabolic Syndrome in Type 2 Diabetes: The Roles of Disease Duration and Glycemic Control</p>

“…Previously, the prevalence of MetS was found to be high in patients with T2D regardless of the method used to diagnose MetS. 21 As expected, the patients with T2D had significant increases in FBG, insulin, and HbA1C levels and HOMA-IR scores compared to nondiabetic individuals in the control group. Similarly, patients with T2D had significantly higher body fat percentage, fat mass, lipid profile, and SBP.…”

“…The sample size was calculated using an online calculator 19 with consideration of the following: 95% confidence interval (CI), power of 80%, a control-to-case ratio of 1:1, the proportion of population without T2D who developed MetS in the 30-40-year-old population in Saudi Arabia (42.7%), 20 and proportion of individuals with T2D who developed MetS in Saudi Arabia (85.8%). 21 Thus, the sample size was set at 20 individuals with T2D and 20 controls.…”

Comparación de diferentes definiciones de síndrome metabólico y su relación con la estimación del riesgo cardiovascular

“…(7,10) En relación con la alta prevalencia de SM encontrada en este estudio, esta puede deberse a que estuvo enfocado en un consultorio dirigido a detectar pacientes con factores de riesgo o con enfermedades crónicas no transmisibles, como hipertensión, diabetes y/o dislipidemias. Otro estudio realizado por Ghamri y Alamri (22) en pacientes con diagnóstico de diabetes mellitus, reporto una mayor prevalencia de SM en comparación con el presente estudio, usando la definición de la NCEP-ATP III (85.8%) frente a la OMS (80%). Posiblemente esta elevada prevalencia de SM según OMS se puede explicar teniendo en cuenta que la población de estos estudios fueron pacientes diabéticos.…”

“…(20) Por otra parte, un estudio en Ecuador reporta dentro de sus resultados, una concordancia casi perfecta (k=0.837) entre las definiciones de SM de la guía JIS y ALAD. (31) Por el contrario, Ghamri y Alamri (22) informaron una concordancia considerable entre NCEP-ATP III y OMS (κ = 0.751). Cabrera-Rode et al (32) informaron un grado de concordancia casi perfecto entre las definiciones de la guia JIS y la IDF, NCEP-ATP III y AHA/NHLBI (1.000, 0.947 y 0.885, respectivamente).…”

Determination of serum tumor necrosis factor-alpha (TNF-α) levels in metabolic syndrome patients from Saudi population

“… 1 , 2 These features may occur individually by chance, but they can raise cardiac risk in combination. 3 As the metabolic syndrome is a complex anomaly, the definition for disease categorization has been explained by various organizations like Adult Treatment Panel III (ATP III), National Cholesterol Education Program (NCEP), the World Health Organization (WHO), and International Diabetes Foundation (IDF)and. 4 …”