title: Components of metabolic syndrome and their combinations as predictors of cardiovascular disease in Japanese patients with type 2 diabetes. Implications for improved definition. Analysis from Japan Diabetes Complications Study (JDCS).
abstract: OBJECTIVE
  The prognostic power of metabolic syndrome (MetS) in patients with diabetes has been studied with inconsistent results depending on the definition of MetS. To clarify the best combination of MetS components to predict future cardiovascular disease (CVD) events, we estimated CVD risk in Japanese patients with type 2 diabetes according to MetS components.
  
  
  METHODS
  Patients were categorized according to the presence three MetS components in addition to hyperglycemia. hypertension, dyslipidemia and excess waist circumference (WC) (according to either Japanese or Asian cut-off values). Hazard ratios for CVD events were compared in patients with various categories of MetS components.
  
  
  RESULTS
  At least two components of MetS were required for a significantly elevated risk for CVD; however, component combinations with significantly increased risk differed depending on gender or the WC cut-off value. Any two among 1) excess WC (men > or =90 cm, women > or =80 cm); 2) hypertension (systolic blood pressure > or =130 mmHg or diastolic blood pressure > or =85 mmHg or use of an antihypertensive agent); and 3) dyslipidemia (triglycerides > or =150 mg/dL or HDL-cholesterol <40 mg/dL or use of drug treatment) could be used to identify significantly higher risk (approximately twice) for CVD regardless of gender.
  
  
  CONCLUSIONS
  The results suggest that the current MetS criteria should be modified when applied to patients with type 2 diabetes.
authors: Department of Internal Medicine, University of Tsukuba Institute of Clinical Medicine, Tsukuba, Japan.
authors: Hirohito
authors: H
authors: Sone
authors: Sachiko
authors: S
authors: Tanaka
authors: Satoshi
authors: S
authors: Iimuro
authors: Koji
authors: K
authors: Oida
authors: Yoshimitsu
authors: Y
authors: Yamasaki
authors: Shinichi
authors: S
authors: Oikawa
authors: Shun
authors: S
authors: Ishibashi
authors: Shigehiro
authors: S
authors: Katayama
authors: Hideki
authors: H
authors: Ito
authors: Yasuo
authors: Y
authors: Ohashi
authors: Yasuo
authors: Y
authors: Akanuma
authors: Nobuhiro
authors: N
authors: Yamada
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology; D050171:Dyslipidemias; D006801:Humans; D006943:Hyperglycemia; D006973:Hypertension; D007564:Japan / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012306:Risk; D012737:Sex Factors; D055105:Waist Circumference