The Metabolic Syndrome Defined by Factor Analysis and Incident Type 2 Diabetes in a Chinese Population With High Postprandial Glucose

Wang, Jianjun; Qiao, Qing; Miettinen, Maija E.; Lappalainen, Jani; Hu, Gang; Tuomilehto, Jaakko

doi:10.2337/diacare.27.10.2429

Cited by 65 publications

(48 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, several putative mechanisms can be proposed. The obesity-related insulin-resistance syndrome, which describes a cluster of metabolic abnormalities (insulin resistance, hypertension, dyslipidaemia and impaired glucose regulation), has been recognised to play an important role in the development of type 2 diabetes [36][37][38][39][40]. A high intake of dietary sodium and the high urinary sodium to potassium ratio have been shown to have a direct relationship with essential hypertension [10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland

et al. 2005

View full text Add to dashboard Cite

Aims/hypothesis: No previous studies on the association between salt intake and the risk of type 2 diabetes have been reported. The aim of this study was to assess whether high salt intake, measured by 24-h urinary sodium excretion, is an independent risk factor for type 2 diabetes. Methods: We followed prospectively 932 Finnish men and 1,003 women aged 35-64 years with complete data on 24-h urinary sodium and potassium excretion and other study parameters. Hazard ratios for the incidence of type 2 diabetes were estimated for different levels of 24-h urinary sodium and potassium excretion. Results: During a mean follow-up of 18.1 years, there were 129 incident cases of type 2 diabetes. The multivariate-adjusted (age, sex, study year, body mass index, physical activity, systolic blood pressure, antihypertensive drug treatment, education, smoking and coffee, alcohol, fruit, vegetable, sausage, bread and saturated fat consumption) hazard ratio for diabetes for the highest vs combined lower quartiles of 24-h urinary sodium excretion was 2.05 (95% CI, 1.43-2.96). This positive association persisted in non-obese and obese subjects, in normotensive and hypertensive subjects, as well as in men and women. Potassium excretion was not associated with the risk of type 2 diabetes. Conclusions/ interpretation: High sodium intake predicted the risk of type 2 diabetes, independently of other risk factors including physical inactivity, obesity and hypertension. These results provide direct evidence of the harmful effects of high salt intake in the adult population, although the confounding effect of other dietary factors cannot be fully excluded.

show abstract

Section: Discussionmentioning

confidence: 99%

Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland

et al. 2005

View full text Add to dashboard Cite

show abstract

“…As shown, all of the studies (24,33,38, [143][144][145][146][147][148][149] found that at least two and usually three to four factors underlie the overall correlation between risk variables, even though different factor analysis methods were used. Shen et al (150), using "confirmatory factor analysis," which provides some advantages and is complementary to exploratory factor analysis, proposed a correlated four-factor model that nicely depicts the major factors related to the syndrome (Fig.…”

Section: Does the Syndrome Reflect A Single Underlying Pathological Pmentioning

confidence: 99%

The Metabolic Syndrome: Time for a Critical Appraisal

et al. 2005

View full text Add to dashboard Cite

The term "metabolic syndrome" refers to a clustering of specific cardiovascular disease (CVD) risk factors whose underlying pathophysiology is thought to be related to insulin resistance. Since the term is widely used in research and clinical practice, we undertook an extensive review of the literature in relation to the syndrome's definition, underlying pathogenesis, and association with CVD and to the goals and impact of treatment. While there is no question that certain CVD risk factors are prone to cluster, we found that the metabolic syndrome has been imprecisely defined, there is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a CVD risk marker. Our analysis indicates that too much critically important information is missing to warrant its designation as a "syndrome." Until much needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the "metabolic syndrome." Diabetes Care 28:2289 -2304, 2005F or most of the 20th century, cardiovascular disease (CVD) was identified as the major cause of morbidity and mortality in the developed world. During this period there was considerable effort to understand the underlying biology of the disease and to identify the contributing risk factors. As risk factors were identified, it became apparent that more than one were often present in the same individual. Toward the end of the century, the clustering of CVD risk factors was first described, most notably the simultaneous presence of obesity, type 2 diabetes, hyperlipidemia, and hypertension (1-3). Although insulin resistance (i.e., resistance to insulin-stimulated glucose uptake) as a feature of type 2 diabetes was first described many years earlier (4), hyperinsulinemia was also found to be a key feature of type 2 diabetes (5,6), as well as hyperlipidemia (7-9), obesity (10 -13), and hypertension (12)(13)(14). In addition, a cluster of heart disease risk factors seemed clearly related to type 2 diabetes (15).This risk factor clustering, and its association with insulin resistance, led investigators to propose the existence of a unique pathophysiological condition, called the "metabolic" (1-3) or "insulin resistance" (11) syndrome. This concept was unified and extended with the landmark publication of Reaven's 1988 Banting Medal award lecture (16). Reaven postulated that insulin resistance and its compensatory hyperinsulinemia predisposed patients to hypertension, hyperlipidemia, and diabetes and thus was the underlying cause of much CVD. Although obesity was not included in Reaven's primary list of disorders caused by insulin resistance, he acknowledged that it, too, was correlated with insulin resistance or hyperinsulinemia, and that the obvious "treatment" for what he termed "syndrome X" was weight maintenance (or weight loss) and physical activity.Reaven's seminal paper was followed by many studies documenting the clustering of CVD risk factors and their relatio...

show abstract

“…As shown, all of the studies [24,33,38,[143][144][145][146][147][148][149] found that at least two and usually three or four factors underlie the overall correlation between risk variables, even though different factor analysis methods were used. Shen and colleagues [150] using 'confirmatory factor analysis', which provides some advantages and is complementary to exploratory factor analysis, proposed a correlated four factor model that nicely depicts the major factors related to the syndrome (Fig.…”

Section: Does the Syndrome Reflect A Single Underlying Pathological Pmentioning

confidence: 99%

The metabolic syndrome: time for a critical appraisal

et al. 2005

View full text Add to dashboard Cite

Background: The term 'metabolic syndrome' refers to a clustering of specific cardiovascular disease (CVD) risk factors whose underlying pathophysiology is thought to be related to insulin resistance. Methods: Since the term is widely used in research and clinical practice, we undertook an extensive review of the literature in relation to the syndrome's definition, underlying pathogenesis, association with cardiovascular disease and to the goals and impact of treatment. Discussion: While there is no question that certain CVD risk factors are prone to cluster, we found that the metabolic syndrome has been imprecisely defined, there is a lack of certainty regarding its pathogenesis, and there is considerable doubt regarding its value as a CVD risk marker. Our analysis indicates that too much critically important information is missing to warrant its designation as a 'syndrome'. Conclusion: Until much-needed research is completed, clinicians should evaluate and treat all CVD risk factors without regard to whether a patient meets the criteria for diagnosis of the 'metabolic syndrome'.

show abstract

The Metabolic Syndrome Defined by Factor Analysis and Incident Type 2 Diabetes in a Chinese Population With High Postprandial Glucose

Cited by 65 publications

References 35 publications

Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland

Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland

The Metabolic Syndrome: Time for a Critical Appraisal

The metabolic syndrome: time for a critical appraisal

Contact Info

Product

Resources

About