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Age-specific Diabetes Risk by the Number of Metabolic Syndrome Components: A Korean Nationwide Cohort Study

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Age-specific Diabetes Risk by the Number of Metabolic Syndrome Components: A Korean Nationwide Cohort Study

Min-Kyung Lee et al. Diabetol Metab Syndr.

Abstract

Background: Metabolic syndrome is associated with an increased risk of diabetes. This study investigated the associations between the number of metabolic syndrome components and diabetes risk by age, sex and BMI.

Methods: Data for 19,475,643 participants ≥ 20 years old with no history of diabetes were obtained between 2009 and 2012 and were accessed using the South Korean National Health Insurance Service. Metabolic syndrome was defined according to the modified criteria of the National Cholesterol Education Program Adult Treatment Panel III. We assessed the risk of diabetes according to the number of metabolic syndrome components after stratifying the study participants into groups by age (20-39, 46-64, ≥ 65 years), sex, and BMI (below or above 25).

Results: During an average of 5.13 years of follow-up, the incidence rates of diabetes increased with the number of metabolic syndrome components. Age and BMI gradually increased with the number of metabolic syndrome components. The multivariable-adjusted hazard ratios (HRs) for incident diabetes were 1.401, 1.862, 2.47, 3.164 and 4.501 for participants with one through five components, respectively, compared with those without metabolic syndrome components. The risk of diabetes was 1.79-, 2.18-, and 3.05-times higher for participants ≥ 65 years; 2.57-, 3.45-, and 5.18-times higher for participants 40-64 years; and 2.55-, 3.89-, and 6.31-times higher for participants 20-39 years of age with three through five components, respectively, compared to those with no components. There was no difference in the risk of diabetes between men and women. The HRs were 5.63 for participants with a BMI ≥ 25 and 3.98 for those with a BMI < 25 among individuals with five components.

Conclusions: The risk of diabetes was more strongly associated with the number of metabolic syndrome components among younger adults. In addition, the risk of diabetes across the number of metabolic syndrome components was greater in participants with a BMI ≥ 25.

Keywords: Diabetes mellitus; Metabolic syndrome; Risk factors; Type 2.

Conflict of interest statement

Competing interestsThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Incidence rates of type 2 diabetes according to the number of metabolic syndrome components by age, sex, and BMI. Incidence rates a by age, b by sex, c by BMI. There was a significant increase in diabetes incidence with numbers of metabolic syndrome components was significant (P < 0.0001)
Fig. 2
Fig. 2
Hazard ratios (95% CI) of type 2 diabetes according to the number of metabolic syndrome components by age, sex, and BMI. Hazard ratios a by age, b by sex, and c by BMI. The interaction between metabolic syndrome components and subgroups (age, sex, and BMI) is statistically significant (P < 0.0001). There was a significant increase in diabetes risk with numbers of metabolic syndrome components (P < 0.0001). Multivariable hazard ratios were adjusted for age, sex, alcohol consumption, smoking status, exercise, income, and BMI. Error bars represent upper 95% CI

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