title: Metabolic syndrome in type 1 diabetes: association with diabetic nephropathy and glycemic control (the FinnDiane study).
abstract: OBJECTIVE
  The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control.
  
  
  METHODS
  In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5%), intermediate (7.5-9.0%), or poor (>9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula.
  
  
  RESULTS
  The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89-4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance.
  
  
  CONCLUSIONS
  The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.
authors.affiliation: Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, POB 63, FIN-00014, Helsinki, Finland.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Thorn
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Johan
authors.initials: J
authors.lastname: Fagerudd
authors.forename: Merlin C
authors.initials: MC
authors.lastname: Thomas
authors.forename: Kim
authors.initials: K
authors.lastname: Pettersson-Fernholm
authors.forename: Markku
authors.initials: M
authors.lastname: Saraheimo
authors.forename: Johan
authors.initials: J
authors.lastname: Wadén
authors.forename: Mats
authors.initials: M
authors.lastname: Rönnback
authors.forename: Milla
authors.initials: M
authors.lastname: Rosengård-Bärlund
authors.forename: Clas-Göran Af
authors.initials: CG
authors.lastname: Björkesten
authors.forename: Marja-Riitta
authors.initials: MR
authors.lastname: Taskinen
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000328:Adult; D017668:Age of Onset; D000419:Albuminuria / Q000453:epidemiology; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence
chemical_list: D001786:Blood Glucose