#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Metabolic syndrome and prediabetic states


Authors: P. Galajda 1;  Michal Mokáň 2;  Marián Mokáň 1
Authors‘ workplace: I. interná klinika Jesseniovej lekárskej fakulty UN Martin, Slovenská republika, prednosta prof. MU Dr. Marián Mokáň, DrSc., FRCP Edin 1;  Jesseniova lekárska fakulta UN Martin, Slovenská republika, dekan prof. MU Dr. Ján Danko, CSc. 2
Published in: Vnitř Lék 2013; 59(6): 453-458
Category: 80th birthday prof. MUDr. Karla Horkého, DrSc., FACP (Hon.)

Overview

Metabolic syndrome is defined as cluster of independent risk factors of coronary heart disease and type 2 diabetes mellitus including prediabetic glucose metabolism disorders associated with insulin resistance as impaired fasting glucose, impaired glucose tole­rance and/ or borderline increasing of glycosylated haemoglobin; central obesity, atherogenic dyslipidaemia with increasing of triglyceride levels and decreasing of high density lipoprotein levels and hypertension. In diagnosis of prediabetic states there are used fasting glycaemia, 2 hours glycaemia during oral glucose tolerant test and HbA1c level, which importance in diagnostic is discussed. In DM2 prevention there is important mainly physical activity at least 30 min daily. In the case of pharmacotherapy there was confirmed efficiency of metformin, which could be used in states with high risk of DM2 conversion and some antihypertensive drugs, mainly sartans. In the case of treatment of dyslipidaemia by statins there is moderate increased risk of DM2 in prediabetic states, but cardiovascular benefit from treatment some times exceeds this risk.

Key words:
metabolic syndrome –  prediabetic states –  type 2 diabetes mellitus –  glycosylated haemoglobin –  metformin –  sartans –  statins


Sources

1. Galajda P. Metabolický syndróm. In: Mokáň M,Martinka E, Galajda P (eds). Diabetes mellitus a vybrané metabolické ochorenia. Martin: P+M 2008: 685– 698.

2. Galajda P, Mokáň M. Aktuálne problémy v oblasti metabolického syndrómu. Ateroskleróza 2012; 16: 238– 243.

3. American Diabetes Association –  International Expert Group. Diagnosis and Classification of Diabetes. Diabetes Care 2010; 33 (Suppl 1): S62– S69.

4. Alberti K, Zimmet FZ for the WHO Consultation: Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications. Part 1: Diagnosis and classification of diabetes mellitus: provisional report of a WHO consultation. Diabetes Medicine 1998; 15: 539– 553.

5. Executive Summary of The Third Report of The National Cholesterol Education Program Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001; 285: 2486– 2497.

6. Bloomgarden ZT. American Association of Clinical Endocrinologists (AACE) consensus conference on insulin resistance syndrome: 25– 26 august 2002, Washington, DC. Diabetes Care 2003; 26: 1297– 1303.

7. Grundy SM, Brewer HB, Cleeman JI et al. Definition of metabolic syndrome. Report of the National Heart, Lung and Blood Institute/ American Heart Association Conference on Scientific Issues Related to Definition. Circulation 2004; 109: 433– 438.

8. International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome (April 14 2005). www.idf.org/ webdata/ docs/ Metab_syndrome_def.pdf.

9. Alberti KG, Eckel RH, Grundy SM et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640– 1645.

10. Faerch K, Borch‑ Johnsen K, Holst JJ et al. Pathophysiology and aetiology of impaired fasting glycaemia and impaired glucose tolerance: does it matter for prevention and treatment of type 2 diabetes? Diabetologia 2009; 52: 1714– 1723.

11. Škrha J. Aktuality v diagnostice diabetes mellitus. Postgrad Med 2011; 13: 399– 402.

12. American Diabetes Association: Standards of medical care in diabetes –  2012. Diabetes Care 2013; 36 (Suppl 1): S11– S66.

13. Cowie CC, Rust KF, Byrd‑ Holt DD et al. Prevalence of diabetes and high risk for diabetes using A1C criteria in the U.S. population in 1988– 2006. Diabetes Care 2010; 33: 562– 568.

14. Lorenzo C, Wagenknecht LE, Hanley AJ et al. A1C between 5.7 and 6.4% as a marker for identifying pre‑diabetes, insulin sensitivity and secretion, and cardiovascular risk factors: the Insulin Resistance Atherosclerosis Study (IRAS). Diabetes Care 2010; 33: 2104– 2109.

15. Rathman W, Kowall B, Tamayo T et al. Hemoglobin A1c and glucose criteria identify different subjects as having type 2 diabetes in mid­dle‑ aged and older populations: the KORA S4/ F4 Study. Ann Med 2012; 44: 170– 177.

16. Bianchi C, Miccoli R, Bonadonna RC et al. Pathogenetic mechanisms and cardiovascular risk: Differences between HbA1c and oral glucose tolerance test for the diagnosis of glucose tolerance. Diabetes Care 2012; 35: 2607– 2612.

17. Bernal‑ Lopez MR, Santamaria‑ Fernandez S,Lopez‑ Carmona D et al. HbA(1c) in adults with­out known diabetes from southern Europe. Impact of the new diagnostic criteria in clinical practice. Diabet Med 2011; 28: 1319– 1322.

18. Succurro E, Marini MA, Arturi F et al. Usefulness of hemoglobin A1c as a criterion to define the metabolic syndrome in a cohort of Italian nondiabetic white subjects. Am J Cardiol 2011; 107: 1650– 1655.

19. Liberopoulos EN, Florentin M, Kei A et al. Comparison of hemoglobin A1c and fasting glucose criteria to diagnose diabetes among people with metabolic syndrome and fasting glucose above 100 mg/dL (5.5 mmol/L). J Clin Hypertens 2010; 12: 543– 548.

20. Lipska KJ, De Rekeneire N, Van Ness PH et al.Identifying dysglycemic states in older adults: implications of the emerging use of hemoglobin A1c. J Clin Endocrinol Metab 2010; 95: 5289– 5295.

21. Herman WH, Ma Y, Uwaifo G et al. Diabetes Prevention Program Research Group. Differences in A1c by race and ethnicity among patients with impaired glucose tolerance in the Diabetes Prevention Program. Diabetes Care 2007; 30: 2453– 2457.

22. Ziemer DC, Kolm P, Wientraub WS et al. Glucose‑independent, black‑ white differences in hemoglobin A1c levels: a cross‑ sectional analysis of 2 studies. Ann Intern Med 2010; 152: 770– 777.

23. Olson DE, Rhee MK, Herrick K et al. Screening for diabetes and pre‑diabetes with proposed A1C‑based diagnostic criteria. Diabetes Care 2010; 33: 2184– 2189.

24. Mostafa SA, Khunti K, Srinivasan BT et al. The potential impact and optimal cut‑ points of using glycated haemoglobin, HbA1c, to detect people with impaired glucose regulation in a UK multi‑ethnic cohort. Diabetes Res Clin Pract 2010; 90: 100– 108.

25. Heianza Y, Hara S, Arase Y et al. HbA1c 5.7– 6.4% and impaired fasting plasma glucose for diagnosis of prediabetes and risk of progression to diabetes in Japan (TOPICS 3): a longitudinal cohort study. Lancet 20119; 378: 147– 155.

26. Yang C, Liu Y, Li X et al. Utility of hemoglobin A1c for the identification of individuals with diabetes and prediabetes in a Chinese high risk population. Scand J Clin Lab Invest 2012; 72: 403– 409.

27. Choi SY, Yun KE, Choi HJ. Risk factors associated with high hemoglobin A1C levels (>-5.7%) in Korean adults with normal fasting glucose. J Endocrinol Invest 2012; 35: 730– 734.

28. Bae JC, Rhee EJ, Lee WY et al. Optimal range of HbA1c for the prediction of future diabetes: a 4‑year longitudinal study. Diabetes Res Clin Pract 2011; 93: 255– 259.

29. Xu L, Jiang CQ, Lam TH et al. Plasminogen activator inhibitor‑ 1 and HbA1c defined prediabetes: the Guangzhou Biobank Cohort Study‑ CVD. Clin Endocrinol (Oxford) 2011; 74: 528– 531.

30. Padwai R, Majumdar SR, Johnson JA et al. A systematic review of drug therapy to delay or prevent type 2 diabetes. Diabetes Care 2005; 28: 736– 744.

31. Diabetes Prevention Program Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393– 403.

32. UK Prospective Diabetes Study Group: Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998; 352: 854– 865.

33. DREAM Trial Investigators: Bosch J, Yunif S, Gerstein HC et al. Effect of ramipril on the incidence of diabetes. N Engl J Med 2006; 12: 1551– 1562.

34. The NAVIGATOR Study Group: Effect of Valsartan on the Incidence of Diabetes and Cardiovascular Events. N Engl J Med 2010; 362: 1477– 1490.

35. DeFronzo RA, Tripathy D, Schwenke DC et al. Pioglitazone for diabetes preventive in impaired glucose tolerance. N Engl J Med 2011; 364: 1104– 1115.

36. Chiasson JL, Josse RG, Gomis L et al. STOP‑ NIDDM Trial Research Group. Acarbose for prevention of type 2 diabetes mellitus: the STOP‑ NIDDM randomised trial. Lancet 2002; 359: 2072– 2077.

37. Torgerson JS, Hauptman J, Boldrin MN et al. XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study. A randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 2004; 27: 155– 161.

38. Sjostrom L, Lindroos AK, Peltonen M et al. For the Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683– 2693.

39. Freeman DJ, Norrie J, Sattar N et al. Pravastatin and the development of diabetes mellitus. Evidence for a protective treatment effect in the West of Scotland Coronary Prevention Study. Circulation 2001; 103: 357– 362.

40. Ridker PM, Pradhan A, MacFadyen JG et al. Cardiovascular benefit and diabetes risk of statin therapy in primary prevention: an analysis from the JUPITER trial. Lancet 2012; 380: 565– 571.

41. Sattar N, Preiss D, Murray HM et al. Statins and the risk of incident diabetes: a collaborative meta‑analysis of randomised clinical trial. Lancet 2010; 375: 735– 742.

42. Preiss D, Seshasai SR, Welsh P et al. Risk of incident diabetes with intensive‑dose compared with moderate‑dose statin therapy. JAMA 2011; 305: 2556– 2564.

43. Navarese EP, Buffon A, Andreotti F et al. Meta‑analysis of impact of different types and doses of statins on new‑onset diabetes mellitus. Am J Cardiol 2013; 111: 1123– 1130.

44. Nakata M, Nagasaka S, Kusaka I et al. Effects of statins on the adipocyte maturation and expression of glucose transporter 4 (SLC2A4): implications in glycaemic control. Diabetologia 2006; 49: 1881– 1892.

45. Dukát A. Vedľajšie nežiaduce účinky liečby statínmi: statíny a manifestácia novozisteného diabetes mellitus 2. typu. Diabetes a obezita 2013; 13. In press.

46. Abuissa H, Jones PG, Marso SM et al. Angiotensin‑converting enzyme inhibitors or angiotensin receptor blockers for prevention of type 2diabetes. A meta‑analysis of randomized clinical trials. J Am Coll Cardiol 2005; 46: 821– 826.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 6

2013 Issue 6

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#