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The Metabolic Syndrome as Predictor of Type 2 Diabetes

Open access
Lorenzo, Carlos, Okoloise, Mayor, Williams, Ken, Stern, Michael P., Haffner, Steven M.·2003·Diabetes Care

Abstract

OBJECTIVE—The oral glucose tolerance test identifies high-risk subjects for diabetes, but it is costly and inconvenient. To find better predictors of type 2 diabetes, we evaluated two different definitions of the metabolic syndrome because insulin resistance, which is commonly associated with this clustering of metabolic factors, frequently precedes the onset of type 2 diabetes. RESEARCH DESIGN AND METHODS—We compared the ability of the National Cholesterol Education Program (NCEP) definition, a modified version of the 1999 World Health Organization (WHO) definition that excludes the 2-h glucose requirement, and impaired glucose tolerance (IGT) to predict incident type 2 diabetes. In the San Antonio Heart Study, 1,734 participants completed a 7- to 8-year follow-up examination. RESULTS—IGT and the NCEP definition had higher sensitivity than the modified WHO definition (51.9, 52.8, and 42.8%, respectively). IGT had a higher positive predictive value than the NCEP and modified WHO definitions (43.0, 30.8, and 30.4%, respectively). The combination of the IGT and NCEP definitions increased the sensitivity to 70.8% with an acceptable positive predictive value of 29.7%. Risk for incidence of type 2 diabetes using the NCEP definition was independent of other risk factors, including IGT and fasting insulin (odds ratio 3.30, 95% CI 2.27-4.80). The NCEP definition performed better with fasting glucose ≥5.4 mmol/l (sensitivity 62.0% and positive predictive value 30.9%). CONCLUSIONS—The metabolic syndrome predicts diabetes independently of other factors. However, the NCEP definition performs better than the modified 1999 WHO definition. Lowering the fasting glucose cutoff to 5.4 mmol/l improves the prediction of diabetes by the metabolic syndrome.

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Metadata

Authors
Lorenzo, C., Okoloise, M., Williams, K., Stern, M. P., & Haffner, S. M.
Venue
Diabetes Care
Published
2003-11-01
Volume
26
Issue
11
Pages
3153-3159
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
OpenAlex
W2032549598
Cited by
803
References
28
FWCI
32.93
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: The Metabolic Syndrome as Predictor of Type 2 Diabetes. https://app.cochat.ai/papers/10.2337/diacare.26.11.3153
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Lorenzo, C., Okoloise, M., Williams, K., Stern, M. P., & Haffner, S. M. (2003). The Metabolic Syndrome as Predictor of Type 2 Diabetes. Diabetes Care. https://doi.org/10.2337/diacare.26.11.3153

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