Prevalence of Metabolic Syndrome and Its Determinants in Newly-Diagnosed Adult-Onset Diabetes in China: A Multi-Center, Cross-Sectional Survey

Xia Li; Chuqing Cao; Xiaohan Tang; Xiang Yan; Houde Zhou; Jing Liu; Linong Ji; Xilin Yang; Zhiguang Zhou

doi:10.3389/fendo.2019.00661

Prevalence of Metabolic Syndrome and Its Determinants in Newly-Diagnosed Adult-Onset Diabetes in China: A Multi-Center, Cross-Sectional Survey

Front Endocrinol (Lausanne). 2019 Oct 1:10:661. doi: 10.3389/fendo.2019.00661. eCollection 2019.

Authors

Xia Li^{1

2

3}, Chuqing Cao^{1

2

3}, Xiaohan Tang^{1

2

3}, Xiang Yan^{1

2

3}, Houde Zhou^{1

3

4}, Jing Liu⁵, Linong Ji⁶, Xilin Yang⁷, Zhiguang Zhou^{1

2

3}

Affiliations

¹ Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.
² Key Laboratory of Diabetes Immunology, Central South University, Ministry of Education, Changsha, China.
³ National Clinical Research Center for Metabolic Diseases, Changsha, China.
⁴ Hunan Key Laboratory for Metabolic Bone Disease, Changsha, China.
⁵ Department of Metabolism & Endocrinology, Gansu Provincial Hospital, Lanzhou, China.
⁶ Department of Metabolism & Endocrinology, Peking University People's Hospital, Beijing, China.
⁷ Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.

Abstract

Aim: The study aimed to investigate the prevalence of metabolic syndrome (MetS) and its determinants in newly-diagnosed adult-onset diabetes in China. Methods: From April 2015 to October 2017, 15,492 consecutive patients with diabetes diagnosed within 1 year and aged ≥30 years were recruited from 46 tertiary care hospitals in 24 cities across China. Glutamic acid decarboxylase autoantibody was assayed centrally and clinical data were collected locally. Classic type 1 diabetes mellitus (T1DM), latent autoimmune diabetes in adults (LADA) and type 2 diabetes mellitus (T2DM) were defined using the criteria of American Diabetes Association, Immunology of Diabetes Society and World Health Organization. MetS was defined using Chinese Diabetes Society's criteria. Logistic regression analysis was used to obtain odds ratios (OR) of determinants of MetS. Results: The overall prevalence of MetS was 66.5%, with the highest prevalence in T2DM (68.1%), followed by those in LADA (44.3%) and T1DM (34.2%) (P < 0.05 for all comparisons). After adjustment for traditional risk factors, T2DM had a 2.8-fold [95% confidence interval (CI): 2.36-3.37] MetS risk compared with LADA, whereas T1DM had significantly lower OR than LADA (OR: 0.68, 95% CI: 0.50-0.92). After further adjustment for insulin resistance, the OR of T2DM vs. LADA was slightly reduced but the OR of T1DM vs. LADA was greatly attenuated to non-significance (OR: 0.96, 95% CI: 0.70-1.33). In addition to types of diabetes, age, gender, geographical residence, education attainment, alcohol consumption and HOMA2-IR were independent determinants of MetS. Conclusions: MetS was highly prevalent, not only in T2DM but also in T1DM and LADA in Chinese newly diagnosed patients; higher risk of MetS in LADA than in T1DM was partially attributable to higher insulin resistance in LADA.

Keywords: insulin resistance; latent autoimmune diabetes in adults; metabolic syndrome; prevalence; type 1 diabetes mellitus; type 2 diabetes mellitus.