(HealthDay News) — For patients with prediabetes who are randomly assigned to interventions, changes in risk indicators of metabolic syndrome (MetS) severity are associated with the risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), according to a study published in the November issue of Diabetes Care.

Mark D. DeBoer, MD, from the University of Virginia in Charlottesville, and colleagues analyzed data for 2476 adults from the Diabetes Prevention Program with prediabetes who were randomly assigned to receive lifestyle modification, metformin, or placebo. Effect sizes were calculated from baseline in a MetS severity z score (MetS-Z) and the individual MetS components. The authors assessed the correlations between effect sizes and incident T2DM and CVD.

The researchers found that baseline MetS-Z and its components correlated with the risk for incident T2DM and CVD. During year one of intervention, the greatest decrease in MetS-Z and its components was seen with lifestyle modification, followed by metformin and placebo. The strongest association was seen for risk for T2DM within 1 to 5 years with 1-year changes in MetS-Z and waist circumference; the risk fpr CVD correlated with one-year change in MetS-Z, glucose, and systolic blood pressure. One-year changes in MetS-Z, waist circumference, glucose, and triglycerides mediated the effect of lifestyle modification on T2DM risk; MetS-Z and glucose mediated the effect of metformin.

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“These factors may serve as important biomarkers of metabolic disarray to identify individuals at highest risk and track the response to treatment,” the authors write.

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DeBoer MD, Filipp SL, and Gurka MJ. Use of a Metabolic Syndrome Severity Z Score to Track Risk During Treatment of Prediabetes: An Analysis of the Diabetes Prevention Program. Diab Care 2018 Sep;dc181079. DOI:10.2337/dc18-1079