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

doi:10.4239/wjd.v11.i5.202

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World Journal of Diabetes

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World J Diabetes. May 15, 2020; 11(5): 202-212
Published online May 15, 2020. doi: 10.4239/wjd.v11.i5.202

Table 1 Anthropometric, laboratory and clinical characteristics of first degree relatives of diabetes mellitus between normal and diabetic subjects in total population and sex difference

Variables	Total			Male			Female
Variables	Diabetes (n = 78)	Normal (n = 630)	P value	Diabetes (n = 26)	Normal (n = 160)	P value	Diabetes (n = 52)	Normal (n = 470)	P value
Age (yr)	43.33 ± 6.15	42.01 ± 6.14	0.075	45.15 ± 7.33	42.83 ± 6.65	0.1	42.42 ± 5.31	41.71 ± 5.93	0.4
BMI (kg/m²)	29.33 ± 4.35	28.16 ± 4.20	0.02	27.6 ± 3.44	26.93 ± 3.64	0.38	30.16 ± 4.53	28.59 ± 4.31	0.01
Smoking, yes [n (%)]	2 (9.5%)	17 (8.03%)	0.84	1 (14.3%)	12 (25%)	0.53	1 (1.1%)	5 (2.3%)	0.43
Education (diploma and more)	33 (42.3%)	317 (51.5%)	0.12	13 (50%)	108 (68.8%)	0.06	20 (38.5%)	208 (45.5%)	0.33
WHR	0.83 ± 0.06	0.81 ± 0.07	0.01	0.9 ± 0.03	0.89 ± 0.05	0.62	0.8 ± 0.04	0.79 ± 0.05	0.04
Blood glucose 0 (mg/dL)	90.45 ± 6.92	87.05 ± 7.91	0.001	91.76 ± 5.58	87.79 ± 8.28	0.01	89.81 ± 7.45	86.8 ± 7.78	0.008
Blood glucose 30 (mg/dL)	143.92 ± 24.56	125.93 ± 24.91	0.001	144.32 ± 25.32	133.08 ± 27.98	0.06	143.73 ± 24.43	123.22 ± 23.14	0.001
Blood glucose 60 (mg/dL)	152.11 ± 34.83	121.58 ± 31.49	0.001	148.88 ± 38.67	129.25 ± 36.37	0.01	153.69 ± 33.06	118.74 ± 29.08	0.001
Blood glucose 120 (mg/dL)	108.93 ± 19.95	97.81 ± 21.05	0.001	102.93 ± 23.43	88.76 ± 22.44	0.003	111.88 ± 17.5	101.01 ± 19.6	0.001
HbA1c	5.2 ± 0.72	4.92 ± 0.78	0.006	5.28 ± 0.9	4.93 ± 0.63	0.03	5.16 ± 0.61	4.92 ± 0.82	0.05
Triglyceride (mg/dL)	181.42 ± 100.22	146.30 ± 81.10	0.001	203.48 ± 97.91	174.98 ± 96.79	0.17	170.6 ± 100.51	136.29 ± 72.42	0.002
Total cholesterol (mg/dL)	203.44 ± 44.55	189.96 ± 38.65	0.005	201.28 ± 40.22	192.09 ± 37.63	0.26	204.5 ± 46.87	189.37 ± 38.93	0.01
HDL (mg/dL)	44.21 ± 10.6	45.33 ± 11.57	0.43	43.34 ± 11.3	40.96 ± 10.82	0.32	44.6 ± 10.36	46.85 ± 11.46	0.18
Systolic pressure (cmHg)	11.58 ± 1.63	11.26 ± 1.48	0.08	12.14 ± 1.61	11.52 ± 1.49	0.06	11.32 ± 1.59	11.17 ± 1.47	0.48
Diastolic pressure (cmHg)	7.45 ± 1.24	7.41 ± 1.12	0.76	7.62 ± 1.16	7.55 ± 1.16	0.87	7.38 ± 1.28	7.36 ± 1.1	0.94

Values are presented as mean ± SD or n (%). BMI: Body mass index; WHR: Waist-to-hip ratio; HbA1c: Hemoglobin A1c; HDL: High-density lipoproteins.

Table 2 Anthropometric, laboratory and clinical characteristics of first degree relatives of type 2 diabetes mellitus between normal and pre-diabetes subjects at total population and sex categories

Variables	Total			Male			Female
Variables	Pre-diabetes (n = 344)	Normal (n = 630)	P value	Pre-diabetes (n = 94)	Normal (n = 161)	P value	Pre-diabetes (n = 250)	Normal (n = 470)	P value
Age (yr)	43.04 ± 6.33	42.01 ± 6.14	0.01	43.2 ± 6.12	42.83 ± 6.65	0.66	42.98 ± 6.42	41.71 ± 5.93	0.008
BMI (kg/m²)	28.44 ± 4.06	28.16 ± 4.2	0.32	26.84 ± 3.56	26.93 ± 3.64	0.84	29.04 ± 4.09	28.59 ± 4.31	0.17
Smoking, yes [n (%)]	8 (7.8%)	17 (8.3%)	0.88	7 (21.2%)	12 (25%)	0.69	1 (1.4%)	5 (3.2%)	0.45
Education (diploma and more)	154 (45.4%)	317 (51.5%)	0.07	61 (66.3%)	108 (68.8%)	0.68	93 (37.7%)	208 (45.5%)	0.05
WHR	0.82 ± 0.06	0.81 ± 0.07	0.04	0.9 ± 0.05	0.89 ± 0.05	0.83	0.8 ± 0.05	0.79 ± 0.05	0.01
Blood glucose 0 (mg/dL)	89.69 ± 6.9	87.05 ± 7.91	0.001	90.57 ± 6.7	87.79 ± 8.28	0.06	89.37 ± 6.96	86.8 ± 7.78	0.001
Blood glucose 30 (mg/dL)	136.63 ± 26	125.93 ± 24.91	0.001	141.44 ± 30.23	133.08 ± 27.98	0.02	134.74 ± 23.94	123.22 ± 23.14	0.001
Blood glucose 60 (mg/dL)	135.68 ± 31.23	121.58 ± 31.49	0.001	134.98 ± 33.37	129.25 ± 36.37	0.21	135.94 ± 30.45	118.74 ± 29.08	0.001
Blood glucose 120 (mg/dL)	104.2 ± 21.36	97.81 ± 21.05	0.001	94.72 ± 23.52	88.76 ± 22.44	0.04	107.7 ± 19.41	101.01 ± 19.6	0.001
HbA1c	5.06 ± 0.7	4.92 ± 0.78	0.009	5.09 ± 0.83	4.93 ± 0.63	0.1	5.05 ± 0.65	4.92 ± 0.82	0.04
Triglyceride (mg/dL)	157.78 ± 81.03	146.3 ± 81.1	0.03	176.98 ± 90.75	174.98 ± 96.79	0.87	150.56 ± 76.02	136.29 ± 72.42	0.01
Total cholesterol (mg/dL)	193.34 ± 38.2	189.96 ± 38.65	0.19	188.09 ± 36.58	192.09 ± 37.63	0.41	195.3 ± 38.67	189.37 ± 38.93	0.05
HDL (mg/dL)	44.37 ± 45.33	10.98 ± 11.57	0.21	41.26 ± 11.46	40.96 ± 10.82	0.83	45.51 ± 10.6	46.85 ± 11.46	0.13
Systolic pressure (cmHg)	11.67 ± 1.65	11.26 ± 1.48	0.001	11.75 ± 1.73	11.52 ± 1.49	0.26	11.64 ± 1.63	11.17 ± 1.47	0.001
Diastolic pressure (cmHg)	7.6 ± 1.14	7.41 ± 1.12	0.01	7.75 ± 1.19	7.55 ± 1.16	0.19	7.55 ± 1.12	7.36 ± 1.1	0.03

Values are presented as mean ± SD or n (%), P values resulted from independent t-test for quantitative and χ² for categorical data. BMI: Body mass index; WHR: Waist-to-hip ratio; HbA1c: Hemoglobin A1c; HDL: High-density lipoproteins.

Table 3 Relationship between metabolic syndrome severity Z-score and risk of diabetes and pre-diabetes in first degree relatives of type 2 diabetes mellitus

	Diabetes, RR (95%CI)			Pre-diabetes, RR (95%CI)
	Total	Male	Female	Total	Male	Female
Crude model	1.94 (1.33-2.82)^a	1.41 (0.65-3.03)	3.83 (2.01-7.29)^a	1.5 (1.2-1.87)^a	1.28 (0.82-1.99)	2.17 (1.53-3.08)^a
Model 1¹	2.69 (1.61-4.48)^a	1.04 (0.69-3.4)	4.01 (2.07-7.76)^a	1.76 (1.33-2.33)^a	1.31 (0.83-2.05)	2.07 (1.45-2.97)^a

¹Age–Sex adjusted for total population and only age adjusted for male and female groups.

^aP < 0.05. RR: Relative risk; CI: Confidence interval.

Table 4 Area under the curve, sensitivity and specificity of metabolic syndrome severity Z-score for predicting the risk of affecting by diabetes and pre-diabetes in future for first degree relatives of type 2 diabetes mellitus when they are normal glucose tolerance at the begging of study

	Diabetes			Pre-diabetes
	Total	Male	Female	Total	Male	Female
AUC (95%CI)	0.63 (0.57-0.69)^a	0.55 (0.43-0.68)	0.67 (0.59-0.74)^a	0.58 (0.54-0.61)^a	0.55 (0.47-0.62)	0.6 (0.55-0.64)^a
Sensitivity (%)	66	76	72	42	71	60
Specificity (%)	56	43	56	72	44	58

^aP < 0.05. AUC: Area under the curve.

Citation: Meamar R, Amini M, Aminorroaya A, Nasri M, Abyar M, Feizi A. 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. World J Diabetes 2020; 11(5): 202-212
URL: https://www.wjgnet.com/1948-9358/full/v11/i5/202.htm
DOI: https://dx.doi.org/10.4239/wjd.v11.i5.202