Utility of the waist-to-height ratio, waist circumference and body mass index in the screening of metabolic syndrome in adult patients with type 1 diabetes mellitus

Background: The incidence of macrovascular complications and morbidities associated to metabolic syndrome are increasing in patients with type 1 diabetes mellitus (T1DM). The combination of T1DM with features of insulin resistance similar to that of type 2 diabetes (T2DM), sometimes called "double diabetes", has been associated with central obesity. Since the most methods to accurately detect body fat and insulin resistance are not readily available, we propose that certain indirect indexes for detecting obesity as waist-to-height ratio, waist circumference and body mass index, may be useful when screening for metabolic syndrome in patients with T1DM. Methods: We performed a transversal evaluation (clinical and biochemical) in all the patients of the T1DM Clinic (n = 120). We determined the presence of metabolic syndrome according to the Joint Statement Criteria by the American Heart Association/National Heart Lung and Blood Institute and the International Diabetes Federation and the utility of certain anthropometric indexes for predicting double diabetes was evaluated. Results: Thirty seven percent of the patients were considered to have metabolic syndrome using these criteria (n = 30). These patients were significantly older (p = 0.002), have a higher glycated hemoglobin (p = 0.036), cholesterol (p < 0.012) and triglyceride concentration (p < 0.01) as well as body mass index (p = 0.004), waist circumference (p = 0.01) and waist-to-height ratio (p < 0.01) than the group without metabolic syndrome. Also their c-HDL is lower (p < 0.01). A value of 0.52 for waist-to-height ratio correctly classified the largest number of patients (68% of correctly classified) well as the waist circumference (66% of correctly classified) with an adequate specificity and sensibility. Meanwhile the most precise body mass index value only classified correctly to 61% of patients. Conclusion: Our data show that waist circumference and waist-to-height ratio indexes are useful to predict the presence of metabolic syndrome in adult patients with type 1 diabetes mellitus.