Relationship of Metabolic Syndrome Defined by IDF or Revised NCEP with Glycemic Control among Malaysians with Type 2 Diabetes

Abstract

Background Chronic complication of Type 2 Diabetes (T2D) such as macrovascular disease is amplified with the increase in the number of the metabolic syndrome (MetS) risk factors. Specific criteria for diagnosis of MetS are essential to help in glycemic control and reduce cardiovascular morbidity and mortality in diabetic patients with metabolic syndrome.Methods The study is cross-sectional observational study which involved 485 T2D patients who are receiving treatment at the University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia. Metabolic syndrome among the T2D patients was diagnosed based on IDF and NCEP-R criteria. C-peptide and glycated hemoglobin (HbA1c) levels were determined by an automated quantitative immunoassay analyzer and high-performance liquid chromatography, respectively. The metabolic syndrome factors, glucose, triglyceride and HDL cholesterol were measured by spectrophotometer Results Application of IDF and NCEP-R criteria respectively resulted in 73% and 85% of T2D subjects being diagnosed with MetS. The concordance of these criteria in diagnosing MetS among T2D was low (κ =0.33, P<0.001). Both IDF and NCEP-R criteria indicated that T2D with five criteria of MetS had higher insulin resistance (P=2.1×10-13, P=1.4×10-11), C-peptide (P=1.21×10-13; 4.1×10-11), blood glucose (P=0.01; 0.021) and HbA1c (P=0.039; 0.018) than those T2D without MetS respectively. Conclusion Although, there is a low concordance between IDF and NCEP-R criteria in the diagnosis of MetS among T2D, both criteria showed that T2D with five criteria of MetS had higher insulin resistance, blood glucose and HbA1c.