title: Impact of metabolic syndrome compared with impaired fasting glucose on the development of type 2 diabetes in a general Japanese population: the Hisayama study.
abstract: OBJECTIVE
  We examined whether metabolic syndrome predicts incident type 2 diabetes more effectively than impaired fasting glucose (IFG) in a general Japanese population.
  
  
  METHODS
  A total of 1,935 nondiabetic subjects aged 40-79 years were followed-up prospectively for a mean of 11.8 years.
  
  
  RESULTS
  During the follow-up, 286 subjects developed type 2 diabetes. Compared with those without metabolic syndrome, the multivariate-adjusted hazard ratio (HR) for incident type 2 diabetes was significantly higher in subjects of both sexes with metabolic syndrome, even after adjustment for confounding factors, age, family history of diabetes, total cholesterol, alcohol intake, smoking habits, and regular exercise (men: HR 2.58 [95% CI 1.85-3.59]; women: 3.69 [2.58-5.27]). The multivariate-adjusted HR of metabolic syndrome for type 2 diabetes was slightly lower in men and similar in women compared with that of IFG. The multivariate-adjusted HR for type 2 diabetes rose progressively as the number of metabolic syndrome components increased in both subjects with and without IFG. In stratified analysis, the multivariate-adjusted risk of type 2 diabetes was significantly higher in subjects with metabolic syndrome alone (2.37 [1.45-3.88]) or IFG alone (3.49 [2.57-4.74]) and markedly increased in subjects with both metabolic syndrome and IFG (6.76 [4.75-9.61]) than in subjects with neither metabolic syndrome nor IFG. Furthermore, the multivariate-adjusted risk for type 2 diabetes was also significantly higher in subjects with both metabolic syndrome and IFG than in those with either one alone (both P < 0.001).
  
  
  CONCLUSIONS
  Our findings suggest that metabolic syndrome significantly increases the risk of incident type 2 diabetes, independent of IFG, and is therefore a valuable tool to identify individuals at high risk of type 2 diabetes.
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Mukai
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Iwase
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000150:complications*; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008487:Medical History Taking; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D002784:Cholesterol