The prevalence of impaired glucose metabolism in Hispanics with two or more risk factors for metabolic syndrome in the primary care setting.
OBJECTIVE
The purposes of this observational prospective study were (a) to identify the prevalence of undiagnosed impaired glucose metabolism (IGM) including impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (T2DM) in 55 Hispanic subjects with two or more risk factors for the metabolic syndrome, (b) to examine the association between glucose metabolism and cardiometabolic risk factors (CMRF), including metabolic syndrome components, and (c) to identify predictors of IGM.


METHODS
Subjects underwent a physical examination and a 2-h 75-g oral glucose tolerance test. Data were analyzed using SAS v9.1 with p < or = .05 considered significant. Nonparametric tests were applied including Mann-Whitney-Wilcoxon test and Spearman correlation coefficient. Stepwise logistic multiple regression was used to predict IGM.


CONCLUSIONS
Twenty-five patients (46%) had IGM (18% IFG, 15% IGT, and 13%T2DM). Normal fasting glucose was found in 48% of subjects who had IGM. Lipid abnormalities were present in 98% including elevated triglycerides (TG 66%), total cholesterol (48%), low-density lipoprotein (68.8%), and low high-density lipoprotein (67.9%). Twenty-nine percent had body mass index (BMI) >25 kg/m(2) and 62% had BMI >30 kg/m, hypertension (24%), and elevated high-sensitivity C-reactive protein (63%), and mean number of cardiometabolic risk factors (#CMRF) was 4.5. Mean values for each risk factor were no different between groups except for #CMRF (p = .0001) and TG (p = .0001). Total #CMRF was the best predictor of IGM.


CONCLUSIONS
The prevalence of IGM is extremely high in Hispanics with metabolic syndrome. Screening for IGM with fasting blood glucose alone underestimates the prevalence of IGM in this population. In subjects with multiple CMRF, screening at lower levels of BMI is warranted.
Neira
Claudia P
CP
University of Tennessee Health Science Center, and University of Tennessee Lifestyle Diabetes and Obesity Care Center, Memphis, Tennessee 38103, USA. cneira@utmem.edu
Hartig
Margaret
M
Cowan
Patricia A
PA
Velasquez-Mieyer
Pedro A
PA
D000328:Adult; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010808:Physical Examination / Q000706:statistics & numerical data; D010865:Pilot Projects; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D002784:Cholesterol