title: A simplified indication of metabolic syndrome to recognize subjects with a moderate risk to develop type 2 diabetes mellitus in a large Italian sample.
abstract: To propose a simplified tool to recognize subjects with a moderate risk to develop type 2 diabetes mellitus (Type 2 DM): this method would take into account only variables from metabolic syndrome definitions which are cheaply assessable. A total of 3,003 employees without diabetes in Italy who attended one annual health examination between 2009 and 2012 were enrolled in this cross-sectional study. A questionnaire was administered along with the annual health examination to record personal and familiar anamnesis. To identify Type 2 DM-prone individuals, the diabetes predictive model by Stern MP et al. was used. Then a multiple logistic regression model was developed using the predicted probability 20%+ of developing Type 2 DM as the outcome variable and a panel of easily measurable continuous baseline characteristics as explanatory variables (waist circumference, WC; body mass index, BMI; and systolic blood pressure, SBP). The optimism-adjusted area under the curve of the proposed model receiver-operating characteristic (ROC) is 0.90. The effects of the explanatory variables on the presumed Type 2 DM risk are summarized by the following adjusted odds ratio values: 2.65 for SBP (P < 0.001), 2.01 for WC (P = 0.04) and 4.64 for BMI (P < 0.001). The satisfactory ROC of the proposed model suggests the importance of simple assessments in the prognostic information on Type 2 DM risk. Such ease of use may be particularly relevant in populations facing the transition from traditional to industrial food who do not have a sophisticated health service yet.
authors.affiliation: Department of Brain and Behavioural Sciences, Section of Neurosciences and Biostatistics, Biostatistics Unit, University of Pavia, Via Agostino Bassi n. 21, 27100, Pavia, Italy, sarasacco.ss@libero.it.
authors.forename: S
authors.initials: S
authors.lastname: Sacco
authors.forename: M
authors.initials: M
authors.lastname: Comelli
authors.forename: V
authors.initials: V
authors.lastname: Molina
authors.forename: P L
authors.initials: PL
authors.lastname: Montrasio
authors.forename: E
authors.initials: E
authors.lastname: Giani
authors.forename: F
authors.initials: F
authors.lastname: Cavanna
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008487:Medical History Taking / Q000379:methods; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D010808:Physical Examination; D011236:Prediabetic State / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires