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Saukkonen T.,University of Oulu | Saukkonen T.,Oulu Occupational Health Center | Jokelainen J.,University of Oulu | Timonen M.,University of Oulu | And 6 more authors.
Scandinavian Journal of Primary Health Care

Objective. Limited data are available on the metabolic syndrome (MetS) and its components in elderly people (aged 70 years and over) at population level in Northern Europe. A study was undertaken to investigate the prevalence of MetS and its components in an aging population by using different definitions. Design, setting, and subjects. A cross-sectional study of 539 inhabitants from Northern Finland (mean age 71.9 years) was conducted to investigate the prevalence of MetS, by using the definitions of MetS by the National Cholesterol Education Panel (NCEP), the modified NCEP (NCEPm), and the International Diabetes Federation (IDF). Main outcome measures. Prevalence of MetS by the NCEP, NCEP modified, and IDF criteria. Results. Overall, the prevalence of MetS was 24.7%, 35.2%, and 37.2% in men, by NCEP, modified NCEP, and IDF-definitions, respectively. In women the corresponding figures were 20.9%, 33.1%, and 47.8%. Hypertension was the most common component in both men (91.8%) and women (89.0%) by the IDF criteria. Glucose abnormalities were particularly prevalent in men (53.2% by NCEP and 78.4% by IDF criteria). Conclusions. The most common component was hypertension in both genders. Lower waist-circumference cut-off points of the IDF criteria led to a higher prevalence of MetS particularly in women. Prevalence of MetS varied significantly when measured by different definitions. Nearly half of older women met the IDF definition of MetS, which was more than twofold when compared with NCEP. Clinical practitioners should be aware of the limitations when using set criteria of MetS, in contrast to identifying the individual cardiovascular risk factors and the accumulation of these. © 2012 Informa Healthcare. Source

Cederberg H.,University of Oulu | Saukkonen T.,University of Oulu | Saukkonen T.,Oulu Occupational Health Center | Laakso M.,University of Oulu | And 6 more authors.
Diabetes Care

OBJECTIVE - A1C has been proposed as a new indicator for high risk of type 2 diabetes. The long-term predictive power and comparability of elevated A1C with the currently used high-risk indicators remain unclear. We assessed A1C, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) as predictors of type 2 diabetes and cardiovascular disease (CVD) at 10 years. RESEARCH DESIGN AND METHODS - This prospective population-based study of 593 inhabitants from northern Finland, born in 1935, was conducted between 1996 and 2008. An oral glucose tolerance test (OGTT) was conducted at baseline and follow-up, and A1C was determined at baseline. Those with a history of diabetes were excluded from the study. Elevated A1C was defined as 5.7- 6.4%. Incident type 2 diabetes was confirmed by two OGTTs. Cardiovascular outcome was measured as incident CVD or CVD mortality. Multivariate log-binomial regression models were used to predict diabetes, CVD, and CVD mortality at 10 years. Receiver operating characteristic curves compared predictive values of A1C, IGT, and IFG. RESULTS - Incidence of diabetes during the follow-up was 17.1%. Two of three of the cases of newly diagnosed diabetes were predicted by a raise in ≥1 of the markers. Elevated A1C, IGT, or IFG preceded diabetes in 32.8, 40.6, and 21.9%, respectively. CVD was predicted by an intermediate and diabetic range of 2-h glucose but only by diabetic A1C levels in women. CONCLUSIONS - A1C predicted 10-year risk of type 2 diabetes at a range of A1C 5.7-6.4% but CVD only in women at A1C ≥6.5%. © 2010 by the American Diabetes Association. Source

Saukkonen T.,University of Oulu | Saukkonen T.,Oulu Occupational Health Center | Cederberg H.,University of Oulu | Jokelainen J.,University of Oulu | And 5 more authors.
Diabetes Care

OBJECTIVE - We compared the prevalences and overlap between intermediate hyperglycemia (IH), defined by a hemoglobin A 1c (A1C) 5.7-6.4%, impaired fasting glucose (IFG), and impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS - Oral glucose tolerance test results and A1C measurements were evaluated asmarkers of IH in an unselected cohort of 486 nondiabetic adults from Finland. RESULTS - The overall prevalence of IH was 34%. Prevalences of isolated A1C 5.7-6.4%, IGT, and IFG were 8.0, 13.2, and 4.5%, respectively. Overlap between these three markers was uncommon. Isolated A1C 5.7-6.4% was associated with a higher BMI compared with isolated IFG and IGT and with a more adverse lipid profile compared with isolated IFG. CONCLUSIONS - Prevalence of isolated IH was high, with limited overlap between the definitions. Differences in cardiovascular disease risk factors were observed among the groups. This study demonstrates that an A1C of 5.7-6.4% detects, in part, different individuals with IH compared with IFG and IGT. © 2011 by the American Diabetes Association. Source

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