title: Metabolic syndrome in subjects at high risk for type 2 diabetes: the genetic, physiopathology and evolution of type 2 diabetes (GENFIEV) study.
abstract: OBJECTIVE
  We evaluated the relationship between insulin resistance (IR) and insulin secretion with the metabolic syndrome (MS) in 885 subjects (377 men/508 women, age 49±11 years, BMI 29±5.2kgm(-2)) at risk of diabetes enrolled in the genetics, pathophysiology and evolution of type 2 diabetes (GENFIEV) study.
  
  
  RESULTS
  All subjects underwent a 75-g oral glucose tolerance test (OGTT) for the estimation of plasma levels of glucose and C-peptide, as well as fasting insulin and lipid profile. IR was arbitrarily defined as HOMA-IR value above the 75th centile of normal glucose tolerance (NGT) subjects. Overall MS prevalence (National Cholesterol Treatment Panel-Adult Treatment Panel (NCEP-ATPIII) criteria) was 33%, 19% in subjects with NGT, 42% in impaired fasting glucose (IFG), 34% in impaired glucose tolerance (IGT), 74% in IFG+IGT subjects, and 56% in newly diagnosed diabetic patients. Prevalence was slightly higher with IDF criteria. MS prevalence was >50% in subjects with 2h glucose >7.8mmoll(-1), independently of fasting plasma glucose. IR prevalence was higher in subjects with MS than in those without (63% vs. 23%; p<0.0001) and increased from 54% to 73% and 88% in the presence of three, four or five traits, respectively. IR occurred in 42% of subjects with non-diabetic alterations of glucose homeostasis, being the highest in those with IFG+IGT (IFG+IGT 53%, IFG 45%, IGT 38%; p<0.0001). Individuals with MS were more IR irrespective of glucose tolerance (p<0.0001) with no difference in insulinogenic index. Hypertriglyceridaemia (OR: 3.38; Confidence Interval, CI: 2.294.99), abdominal obesity (3.26; CI: 2.18-4.89), hyperglycaemia (3.02; CI: 1.80-5.07) and hypertension (1.69; CI: 1.12-2.55) were all associated with IR.
  
  
  CONCLUSIONS
  These results show that in subjects with altered glucose tolerance (in particular IFG+IGT) MS prevalence is high and is generally associated to IR. Some combinations of traits of MS may significantly contribute to identify subjects with IR.
authors.affiliation: Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Diseases, University of Pisa, Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bianchi
authors.forename: R
authors.initials: R
authors.lastname: Miccoli
authors.forename: R C
authors.initials: RC
authors.lastname: Bonadonna
authors.forename: F
authors.initials: F
authors.lastname: Giorgino
authors.forename: S
authors.initials: S
authors.lastname: Frontoni
authors.forename: E
authors.initials: E
authors.lastname: Faloia
authors.forename: G
authors.initials: G
authors.lastname: Marchesini
authors.forename: M A
authors.initials: MA
authors.lastname: Dolci
authors.forename: L
authors.initials: L
authors.lastname: Alviggi
authors.forename: A
authors.initials: A
authors.lastname: Gnasso
authors.forename: A
authors.initials: A
authors.lastname: Consoli
authors.forename: F
authors.initials: F
authors.lastname: Cavalot
authors.forename: M G
authors.initials: MG
authors.lastname: Cavallo
authors.forename: F
authors.initials: F
authors.lastname: Leonetti
authors.forename: A
authors.initials: A
authors.lastname: Giaccari
authors.forename: S
authors.initials: S
authors.lastname: Del Prato
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D006973:Hypertension / Q000503:physiopathology; D007333:Insulin Resistance; D007558:Italy; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000235:genetics* / Q000503:physiopathology*; D008875:Middle Aged; D011236:Prediabetic State; D015995:Prevalence; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D002096:C-Peptide