title: Development of diabetes in Chinese with the metabolic syndrome: a 6-year prospective study.
abstract: OBJECTIVE
  We investigated the association of the metabolic syndrome with new-onset diabetes in the Hong Kong Cardiovascular Risk Factor Prevalence Study cohort.
  
  
  METHODS
  We followed up on 1,679 subjects without diabetes at baseline. Those with a previous diagnosis of diabetes or those who were receiving drug treatment were considered to be diabetic. The remaining subjects underwent a 75-g oral glucose tolerance test (OGTT). Diabetes was defined by plasma glucose > or =7.0 mmol/l with fasting and/or > or =11.1 mmol/l at 2 h.
  
  
  RESULTS
  The prevalences of the metabolic syndrome at baseline were 14.5 and 11.4%, respectively, according to U.S. National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) criteria. After a median of 6.4 years, there were 66 and 54 new cases of diabetes in men and women, respectively. The metabolic syndrome at baseline predicted incident diabetes. Hazard ratios (HRs) for the NCEP and IDF definitions of the syndrome were 4.1 [95% CI 2.8-6.0] and 3.5 [2.3-5.2], respectively. HRs for fasting plasma glucose (FPG) > or =6.1 or 5.6 mmol/l were 6.9 [4.1-11.5] and 4.1 [2.8-6.0], respectively. The NCEP and IDF criteria had 41.9 and 31.7% sensitivity and 87.5 and 90.2% specificity, respectively. Their positive predictive values were low, approximately 20%, but their negative predictive values were approximately 95%.
  
  
  CONCLUSIONS
  The metabolic syndrome, particularly its component, elevated FPG, predicts diabetes in Chinese. An individual without the metabolic syndrome is unlikely to develop diabetes, but one who has it should practice therapeutic lifestyle changes and have periodic FPG measurements to detect new-onset diabetes.
authors.affiliation: Department of Medicine, University of Hong Kong, Hong Kong, China. mycheung@hkucc.hku.hk
authors.forename: Bernard M Y
authors.initials: BM
authors.lastname: Cheung
authors.forename: Nelson M S
authors.initials: NM
authors.lastname: Wat
authors.forename: Yu Bun
authors.initials: YB
authors.lastname: Man
authors.forename: Sidney
authors.initials: S
authors.lastname: Tam
authors.forename: G Neil
authors.initials: GN
authors.lastname: Thomas
authors.forename: Gabriel M
authors.initials: GM
authors.lastname: Leung
authors.forename: Chun Ho
authors.initials: CH
authors.lastname: Cheng
authors.forename: Jean
authors.initials: J
authors.lastname: Woo
authors.forename: Edward D
authors.initials: ED
authors.lastname: Janus
authors.forename: Chu Pak
authors.initials: CP
authors.lastname: Lau
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
authors.forename: Karen S L
authors.initials: KS
authors.lastname: Lam
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors