Diagnosing metabolic syndrome in type 2 diabetes: does it matter?

Metabolic syndrome (MetS) is used as a clinical tool to identify individuals at risk of cardiovascular disease (CVD) but its clinical value in the management of type 2 diabetes mellitus (T2DM) remains uncertain.

To determine the prevalence and clinical usefulness of MetS among patients with T2DM attending diabetes clinics in a large teaching hospital.

Prospective observational study.

Prevalence of MetS was determined by using International Diabetes Federation (IDF) and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) definitions in relation to age, sex, diabetes duration and history of CVD.

A total of 390 patients were included in this study. Both IDF and NCEP-ATPIII definitions identified high prevalence of MetS in male and female patients (IDF: male vs. female, 91.7 vs. 94.8% and NCEP-ATPIII: male vs. female, 87.6 vs. 94.2%) regardless of age (below vs. above 40 yrs, approximately 70-75 vs. approximately 90-95% with both definitions), diabetes duration (below vs. above 5 yrs, approximately 85-90 vs. 90-95% with both definitions) and history of CVD (without vs. with CVD, approximately 90 vs. approximately 95% with both definitions). Central obesity was common reflected by mean waist circumference of approximately 113 cm regardless of age and gender. Among those who did not have IDF-defined MetS, approximately 60% had at least two CVD risk factors. Both definitions similarly classified approximately 94% of the patients as either having or not having MetS.

Both definitions can be used interchangeably to diagnose MetS. However, the clinical usefulness of MetS is debatable given the very high prevalence of this condition in T2DM.