The metabolic syndrome influences the risk of chronic complications in patients with type II diabetes.
OBJECTIVE
We examined features of the metabolic syndrome to see if they modified the risk of chronic diabetic complications in patients with Type II (non-insulin-dependent) diabetes mellitus.


METHODS
A total of 85 randomly selected patients with the metabolic syndrome (WHO definition) were compared with 85 Type II diabetic patients matched for age, sex, duration of diabetes, glycaemic control and without the syndrome to assess the microvascular and macrovascular complications.


RESULTS
The patients with the metabolic syndrome had a higher prevalence of cardiovascular disease (52 vs 21%, p < 0.001), microalbuminuria or macroalbuminuria (23 vs 7%, p = 0.003) and distal neuropathy (16 vs 6%, p = 0.048) than patients without the syndrome. The patients with the metabolic syndrome had smaller LDL particle size (25.4+/-1.4 vs 26.4+/-1.1 nm; p < 0.001), which correlated with the ratio of serum triglycerides to HDL cholesterol (r = -0.64, p < 0.001). In a multiple logistic regression analysis the metabolic syndrome was associated with coronary heart disease (RR 3.84, p < 0.001) and microalbuminuria (RR 3.99, p = 0.01). Small LDL particle size was independently associated with neuropathy (RR 0.58; p = 0.04), whereas a high HbA1c was related to neuropathy (RR 1.69, p = 0.04), retinopathy (RR 1.53, p = 0.002) and microalbuminuria (RR 1.54, p = 0.01).


CONCLUSIONS
Although chronic hyperglycaemia is the main predictor of microvascular complications in patients with Type II diabetes, this risk is modified by some of the components of the metabolic syndrome.
Isomaa
B
B
Jakobstad Hospital, Finland. bo.isomaa@fimnet.fi
Henricsson
M
M
Almgren
P
P
Tuomi
T
T
Taskinen
M R
MR
Groop
L
L
D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology; D001824:Body Constitution; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000502:physiology; D008875:Middle Aged; D010316:Particle Size; D012044:Regression Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D008077:Lipoproteins, LDL; D014280:Triglycerides