| Objective: To explore the relationship between metabolic syndrome(Met S) and its components with the incidence of type 2 diabetes, and study the relationship between clustering of the components of Met S with the incidence of diabetes.Methods: Baseline survey was conducted in 2002-2003 in 32 countries of Naiman banner and Kezuohouqi banner, Tongliao, Inner Mongolia, and 2589 participants aged 20 years and older were recruited. Written informed consent was obtained for all study participants. The trained investigators collected demographic information and lifestyle information by using questionnaire, and measured height, weight and plasma glucose. We re-investigated the cohort participants during the period from 2013 to 2014. We collected history of disease and medicine, measured fasting plasma glucose and 2-hour plasma glucose. After data collection completed, all the questionnaires were collated, and we established a database with Epidata3.1. The associations between Met S and type 2 diabetes were assessed by multivariate logistic regression analysis. All p-values were based on a two-sided test and a significance level of 0.05 was used. Statistical analysis was conducted using SAS statistical software(version 9.1).Results: Among 2589 participants, 94 diabetes patients(fasting glucose ≥7.0mmol/L) and 52 without complete key variables were excluded in the present study. Finally, 2443 individuals were included in this study at baseline. Among 2443 participants, 249 were death and 305 were lost to follow up, and a total of 1889 people(male 722, female 1167) were included in final analysis.1、In the study, the prevalence of Met S was 24.83% among the Mongolian people according to the definition of modified Asian ATPIII, and women(28.28%) had higher prevalence of Met S compared with men(19.25%). Among five components of Met S, prevalence of low HDL-C(54.90%) was the highest, followed by high blood pressure(46.32%), central obesity(35.20%), abnormal FPG(19.69%) and high TG(15.35%). Women have higher prevalence of central obesity and low HDL-C than men, while men have higher prevalence of high blood pressure and high TG than women. There was no significant difference in FPG between men and women.2、We have followed participants for an average of 9.2 years. 249 were death, 305 were lost to follow up and the follow-up rate was 77.32%. A total of incident 204 diabetes(male 83; female 121) were observed during follow-up period and cumulative incidence rate was 10.67%, and the incidence density was 98.05/10000 person-years, which were 105.67/10000 person-years in men and 95.20/10000 person-years in women.3、The participants with incident diabetes had higher proportions of low HDL-C, high blood pressure, central obesity, abnormal FPG and high TG at the baseline of this study compared with those without diabetes. In addition, we found that whatever in men or women, people with diabetes had higher proportions of low HDL-C, high blood pressure, central obesity, abnormal FPG and high TG at the baseline of this study compared with those without diabetes.4、Multivariable logistic regression analysis results showed that the risk of type 2 diabetes in participants with Met S increased significantly, compared with those without Met S, and the ORs was 3.53(2.56-4.87). With the degree of aggregation of Met S components increased, the risk of diabetes was also increased, the test for trend(P<0.001) was statistically significant. For the components of Met S, we found that central obesity, high blood pressure, high TG, low HDL- C and abnormal FPG were associated with increased risk of diabetes, and ORs were 2.05(1.45-2.91), 1.56(1.11-2.18), 1.58(1.04-2.39), 1.87(1.24-2.82) and 2.33(1.66-3.28).5、After stratified according to gender, the risk of type 2 diabetes in participants with Met S increased significantly, compared with those without Met S whatever in men or women, and ORs were 2.96(1.77-4.97) and 3.65(2.38-5.59). With the degree of aggregation of Met S components increased, the risk of diabetes was also increased, the test for trend(P<0.001) was statistically significant. For the five components of Met S, low HDL-C and abnormal FPG were associated with increased risk of diabetes in men, and the ORs were 2.50(1.42-4.42) and 1.81(1.03-3.21). In addition, central obesity, high blood pressure, high TG and abnormal FPG were associated with increased risk of diabetes in women, and ORs were 2.48(1.56-3.95), 1.58(1.02-2.45), 2.16(1.22-3.84) and 2.74(1.76-4.26).Conclusions:1、The incidence of type 2 diabetes is high in the study, and type2 diabetes has become an important disease and public health issues threaten to the health and lives of local Mongolian.2、The risk of type 2 diabetes in participants with Met S increased significantly, compared with those without Met S.3、With the degree of aggregation of Met S components increased, the risk of diabetes was increased significantly. In the total population, all the five components of Met S were associated with increased risk of diabetes. Low HDL-C and abnormal FPG were associated with increased risk of diabetes in men and central obesity, high blood pressure, high TG and abnormal FPG were associated with increased risk of diabetes in women. |
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