Abstract

Background and Objective: Metabolic syndrome (MetS) is a cluster of metabolic factors. Studies have reported on diabetes prevalence in this population. The aim of this study was to determine the prevalence of type 2 diabetes mellitus (T2DM) in MetS in Saudi population.

Methods: We analyzed 1967 participants who are equal to or older than 18 years old. All cases were from the population of the primary health at King Fahad Armed Forces Hospital. All data were collected by personal interview and based on a review of electronic medical records. Physician and nurse interviewers measured and recorded weight (kg) and height (cm). Metabolic risk factors were defined using the 2006 IDF criteria that define elevated triglyceride as ≥150mg/dL (≥1.7mmol/L) and reduced HDL as <40mg/dL (<1.03mmol/L) for male and as <50mg/dL (<1.29mmol/L) for female. Hypertension was defined when the systolic blood pressure was ≥130mm Hg and/or diastolic blood pressure was ≥85mm Hg in addition to receiving any medication for hypertension. Abnormal glucose metabolism was con¬sidered when HbA1c (≥5.7) or when patients were known to have T2DM. Participants were defined as having T2DM according to self-report, clinical reports, use of antidiabetic agents and HbA1c (≥6.5). Body mass index (BMI) values classified into groups as lean (BMI <18.5), normal weight (BMI=18.5-24.9kg/m2), overweight (BMI=25.0-29.9kg/m2), obese (BMI≥30kg/ m2. The total number of cohorts were separated on basis of age values into five groups: <30 years, 30-39 years, 40-49 years, 50-59 years and ≥60 years.

Main results: Of the 1967 participants with MetS analyzed, 763 (38.8%) were male and 1204 (61.2%) were female. Age was 54.5±12.8 (minimum 18 years and maximum 105 years) and mean BMI 31.9±6.6. T2DM was present in 1524 cases (77.5%) where 607 (39.8%) were male and 917 (60.2%) were female with female to male ratio 1.5:1, P=0.08. Males were no significantly older than females in MetS with T2DM patients (56.2±12.2 vs. 48.7±13.1 respectively, p<0.0001). BMI was no significantly higher in males than females with MetS with T2DM patients (32.0±6.8 vs. 31.4±5.8respectively, p=0.1). MetS with T2DM prevalence is consistently increasing with increasing age until the sixth decade (p<0.0001). Moreover, higher prevalence is among age group ≥60 years of age in males. MetS with T2DM prevalence is consistently increasing with increasing BMI category with higher prevalence than MetS without T2DM at the BMI ≥30kg/m2. Higher prevalence is among females in Mets with T2DM. Mean BMI in population of MetS with T2DM is consistently decreasing with increasing age until the sixth decade after a peak at the age 30-39 years (p<0.0001). Moreover, Mean BMI in population of MetS with T2DM is higher among female group with curve separated starting at the age <30 years. The mean of BMI among MetS is statistically significant negatively correlated with increasing with advanced age (r=-0.1, p<0.0001).

Conclusion: The prevalence of T2DM among Saudis with MetS is relatively high. Old age and obesity can be regarded as related factors.

Keywords: Type 2 diabetes mellitus and metabolic syndrome