Utility of Continuous Metabolic Syndrome Score in Assessing Risk of Type 2 Diabetes: The Isfahan Diabetes Prevention Study

Background/Aim: It is not clear whether levels of continuous metabolic syndrome (cMetS) are associated with type 2 diabetes (T2D). The aim of this study was to determine the ability of the cMetS score to predict progression to T2D in non-diabetic first-degree relatives (FDRs) of patients with T2D in Isfahan, Iran. Methods: A total of 1,869 non-diabetic FDRs 30-70 years old in 2003-2005 were followed through 2014 for the occurrence of T2D. At baseline and through follow- ups, participants underwent a standard 75 g 2-h oral glucose tolerance test. MetS was defined by the National Cholesterol Education Program-Adult Treatment Panel III. The cMetS score was calculated using age- and gender-standardized Z-score for MetS components. Receiver operating characteristic (ROC) curve was used to assess the association between cMetS and components of MetS with T2D. Results: During 13,571 person-years of follow-up, 72 men and 210 women developed diabetes. Those in the top quartile of cMetS were 8.0 times more likely to develop diabetes than those in the bottom quartile (OR 7.96; 95% CI 4.88-12.99). On ROC curve analysis, a higher area under the ROC were found for FPG (74.3%; 95% CI 70.8-77.8), than for cMetS (69.4%; 95% CI 66.0-72.8). Conclusions: The cMetS score is a robust predictor of T2D and may be more effective and efficient than the current binary definition of MetS in predicting progression to T2D in our study population. (C) 2015 S. Karger AG, Basel