Prospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2020; 11(5): 202-212
Published online May 15, 2020. doi: 10.4239/wjd.v11.i5.202
Severity of the metabolic syndrome as a predictor of prediabetes and type 2 diabetes in first degree relatives of type 2 diabetic patients: A 15-year prospective cohort study
Rokhsareh Meamar, Masoud Amini, Ashraf Aminorroaya, Maryam Nasri, Majid Abyar, Awat Feizi
Rokhsareh Meamar, Isfahan Endocrine and Metabolism Research Center, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Masoud Amini, Ashraf Aminorroaya, Majid Abyar, Awat Feizi, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Maryam Nasri, Grovemead Health Center, London NW4-3EB, United Kingdom
Awat Feizi, Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
Author contributions: Amini M generated the idea and designed the Isfahan diabetes prevention study, participated in most of the experiments, revising the paper critically for important intellectual content; Meamar R generated the idea and designed the current secondary study, wrote all major parts of the article and checked it for intellectual content and revised it; Feizi A supervised the current secondary study and drafted the paper and revised it critically for important intellectual content and performed all statistical analyses; Aminorroaya A essentially participated as co-investigator in Isfahan diabetes prevention study, revised paper critically for important intellectual content; Nasri M edited and resolved grammatical errors in the article; Abyar M assisted in data collection and preparation and statistical analysis.
Supported by Isfahan Endocrine and Metabolism Research Center, No. 95017.
Institutional review board statement: The study was reviewed and approved by the institutional review boards of Isfahan University of Medical Sciences, Isfahan, Iran. Study project number: 95017.
Informed consent statement: All study participants, provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Awat Feizi, PhD, Professor, Statistician, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, P.O. Box 319, Hezar-Jerib Ave, Isfahan 81746-73461, Iran. awat_feiz@hlth.mui.ac.ir
Received: December 16, 2019
Peer-review started: December 16, 2019
First decision: January 6, 2020
Revised: March 16, 2020
Accepted: March 23, 2020
Article in press: March 23, 2020
Published online: May 15, 2020
Processing time: 147 Days and 2.4 Hours
ARTICLE HIGHLIGHTS
Research background

There is potential links between MetS Z-score as a marker for prediabetes or type 2 diabetes mellitus (T2DM) risk.

Research motivation

Iran is a developing country and its population is adopting a more sedentary lifestyle with new diets resulting in a high prevalence of T2DM and prediabetes.

Research objectives

In this study, the association the of severity of MetS Z-score in FDRs of T2DM was assessed with the risk of prediabetes and type 2 diabetes in future.

Research methods

In a prospective cohort study during a long-term follow-up period for the first time in Iran and as one of scare studies around the world we evaluated the predictive role of MetS Z-score for prediabetes and diabetes incidence risk in future among normal glucose tests. Our study results help clinicians to identify and treat this high-risk population through conducting of interventions for preventing MetS or diminishing its side effects.

Research results

MetS Z-score at the baseline, is a significant predictor for developing future T2DM and prediabetes in total population and female group. Reliable cut off values with high accuracy were obtained in the receiver operating characteristic curve analysis based on the MetS Z-score for differentiating patients with diabetes and prediabetes from the normal population.

Research conclusions

MetS Z-score is a significant predictor for incidence of diabetes and prediabetes risk in future in high risk population of FDR and cut off value for MetS score was not notably different for those people who affected by diabetes and prediabetes. This negligible difference between two groups in terms of cut off values highlights the importance of intervention at the prediabetes stage.

Research perspectives

The FDR people with high risk of developing diabetes and prediabetes are identifiable based on MetS Z-score. Accordingly, appropriate interventions at an earlier stage in MetS may be considered as an effective strategy for preventing the development of diabetes and prediabetes in such a high-risk population.