title: The metabolic syndrome as a predictor of incident diabetes mellitus in Mauritius.
abstract: OBJECTIVE
  To assess the utility of the metabolic syndrome (MetS) and a Diabetes Predicting Model as predictors of incident diabetes.
  
  
  METHODS
  A longitudinal survey was conducted in Mauritius in 1987 (n = 4972; response 80%) and 1992 (n = 3685; follow-up 74.2%). Diabetes status was retrospectively determined using 1999 World Health Organization (WHO) criteria. MetS was determined according to four definitions and sensitivity, positive predictive value (PPV), specificity and the association with incident diabetes before and after adjustment for MetS components calculated.
  
  
  RESULTS
  Of the 3198 at risk, 297 (9.2%) developed diabetes between 1987 and 1992. The WHO MetS definition had the highest prevalence (20.3%), sensitivity (42.1%) and PPV (26.8%) for prediction of incident diabetes, the strongest association with incident diabetes after adjustment for age and sex [odds ratio 4.6 (3.5-6.0)] and was the only definition to show a significant association after adjustment for its component parts (in men only). The low prevalence and sensitivity of the International Diabetes Federation (IDF) and ATPIII MetS definitions resulted from waist circumference cut-points that were high for this population, particularly in men, and both were not superior to a diabetes predicting model on receiver operating characteristic analysis.
  
  
  CONCLUSIONS
  Of the MetS definitions tested, the WHO definition best identifies those who go on to develop diabetes, but is not often used in clinical practice. If cut-points or measures of obesity appropriate for this population were used, the IDF and ATPIII MetS definitions could be recommended as useful tools for prediction of diabetes, given their relative simplicity.
authors.affiliation: International Diabetes Institute, Melbourne, Australia. acameron@idi.org.au
authors.forename: A J
authors.initials: AJ
authors.lastname: Cameron
authors.forename: P Z
authors.initials: PZ
authors.lastname: Zimmet
authors.forename: S
authors.initials: S
authors.lastname: Soderberg
authors.forename: K G M M
authors.initials: KG
authors.lastname: Alberti
authors.forename: R
authors.initials: R
authors.lastname: Sicree
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
authors.forename: P
authors.initials: P
authors.lastname: Chitson
authors.forename: J E
authors.initials: JE
authors.lastname: Shaw
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008436:Mauritius / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000145:classification / Q000453:epidemiology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D049629:Waist-Hip Ratio
chemical_list: D001786:Blood Glucose