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- May 11, 2008 |
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"Prevalence of the Metabolic Syndrome, and the Ability of 3 Definitions to Identify Incident Cases of Diabetes in Australia"Prof. Jonathan Shaw (biography)
English - 2005-04-14 - 24 minutes
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 | (16 slides) |
Summary :
The World Health Organisation (WHO), the (American) National Cholesterol Education Program (NCEP) and the European Group for the study of Insulin Resistance (EGIR) have recently developed independent definitions of the metabolic syndrome (MS). Data from the Australian AusDiab study (1999), and the 5 year follow-up, have been used to calculate the national prevalence of the MS and the ability of the MS to identify individuals with low insulin sensitivity at baseline, as well as 5 year diabetes incidence among those with the MS. The baseline analysis is based on 7875 adults aged >35 without diabetes, while the follow-up analysis is based on 1285 participants followed up thus far (follow-up due for completion in 2005). The prevalence of the metabolic syndrome was 20.8%, 15.8% and 18.4% using the WHO, EGIR and NCEP definitions respectively and was higher among males, although this was not significant for the NCEP definition (WHO: M=25.2%, F=16.6%, p<0.0001; EGIR: M=18.4%, F=13.2%, p= 0.003; NCEP: M=19.6%, F=17.2%, p=0.062). The group identified by the EGIR definition are less insulin sensitive (HOMA-S=34.1%) than those identified by the WHO and/or NCEP definitions (but not EGIR) (HOMA-S=74.9%). This group have insulin sensitivity resembling that of the population without the MS (HOMAS=77.3%). The EGIR definition also has a better positive predictive value for incident diabetes (8.2%) than either the WHO (7.0%) or NCEP (6.9%) definitions. Around 20% of Australians have the MS, with the EGIR definition identifying those who are least insulin sensitive and being the best predictor of diabetes over 5 years.
Learning objectives :
After viewing this presentation, participants will be able to discuss:
• The prevalence of the metabolic syndrome in Australia, using 3 commonly used definitions (WHO, EGIR, ATP-III) as found in the AusDiab Study
• The capacity of the metabolic syndrome to predict incident diabetes
• The degree of insulin resistance associated with each of the 3 definitions
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