Non-traditional markers of atherosclerosis potentiate the risk of coronary heart disease in patients with type 2 diabetes and metabolic syndrome.
OBJECTIVE
The aims of this study were to establish the prevalence of metabolic syndrome (MS), in type 2 diabetes mellitus (DM), according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and to assess the association of MS with other cardiovascular (CV) risk factors in these patients.


RESULTS
A cross-sectional study was conducted in 1610 patients with type 2 DM. Glycated hemoglobin A1c (HbA1c), total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), uric acid, fibrinogen, creatinine, and albumin/creatinine ratios were measured. The risk of coronary heart disease (CHD) was calculated using the UKPDS Risk Engine. Seventy percent of the diabetic population met the criteria for MS; central obesity and hypertension were the most common criteria. Subjects with MS had higher levels of HbA1c, LDL-C, non-HDL-C, uric acid, and fibrinogen compared to patients without MS. Similarly, microalbuminuria and a high triglyceride (Tg)/HDL-C ratio (a marker of small LDL-C) occurred more frequently in patients with MS. When patients with no history of CHD events were considered, mean CHD risk was greater in those with, than those without, MS.


CONCLUSIONS
MS is highly prevalent in type 2 DM and is commonly associated with non-traditional CV risk factors. The diagnosis of MS seems to confer additional CHD risk in patients with type 2 diabetes.
Bianchi
Cristina
C
Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Disease, University of Pisa, Ospedale Cisanello, Via Paradisa 2, 56126 Pisa, Italy.
Penno
Giuseppe
G
Malloggi
Lucia
L
Barontini
Rossana
R
Corfini
Marisa
M
Giovannitti
Maria G
MG
Di Cianni
Graziano
G
Del Prato
Stefano
S
Miccoli
Roberto
R
D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003404:Creatinine; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D012709:Serum Albumin; D014527:Uric Acid; C517652:hemoglobin A1c protein, human