Increased prevalence of microvascular complications in type 2 diabetes patients with the metabolic syndrome.
BACKGROUND
Microvascular complications of diabetes contribute significantly to the disease morbidity. The metabolic syndrome is common among subjects with diabetes and is a very important risk factor for macrovascular complications. However, its contribution to the microvascular complication has not been assessed.


OBJECTIVE
To assess the risk of microvascular complications associated with the metabolic syndrome in diabetes subjects.


METHODS
The study group comprised 415 diabetic subjects attending a primary care clinic. The prevalence of microvascular complications was compared between 270 diabetic subjects with metabolic syndrome (NCEP-III criteria) and 145 diabetic patients without.


RESULTS
We found that as a group, diabetic subjects with metabolic syndrome had a significantly higher frequency of microvascular-related complications than diabetic subjects without the syndrome (46.6% and 26.8% respectively, P= 0.0005). These include microalbuminuria (41.5% vs. 23.9%, P= 0.013), neuropathy (10.4% vs. 7.5%, P = 0.38), retinopathy (9.6% vs. 4.1%, P = 0.046) and leg ulcers (7.9% vs. 2.8%, P = 0.044). After adjustment for age, gender, glycemic control, disease duration, lipid profile and blood pressure, metabolic syndrome was associated with a significantly higher risk of microvascular complications: odds ratio (95% confidence interval) for nephropathy 2.27 (1.53-3.34), neuropathy 1.77 (0.79-4.0), retinopathy 3.42 (1.2-9.87), and leg ulcers 3.57 (1.08-11.95).


CONCLUSIONS
In addition to hyperglycemia and disease duration, the metabolic syndrome is a significant risk factor for the development of microvascular complications in diabetic subjects.
Abdul-Ghani
Muhammad
M
Department of Diabetes, Lin Medical Center, Clalit Health Services, Haifa, Israel. abdulghani@uthscsa.edu
Nawaf
Gamal
G
Nawaf
Fawaz
F
Itzhak
Baruch
B
Minuchin
Oscar
O
Vardi
Pnina
P
D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000209:etiology*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000209:etiology; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007871:Leg Ulcer / Q000453:epidemiology / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008833:Microcirculation; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors