Weight, the metabolic syndrome, and coronary heart disease in type 2 diabetes: associations among a national French sample of adults with diabetes-the ENTRED study.
The authors examined whether obesity alone or as part of the metabolic syndrome (MS) increases coronary heart disease (CHD) risk in type 2 diabetes mellitus (T2DM) among 2970 adults aged 30-79 years in a French national sample. MS was defined as T2DM plus self-report of 2 or more of the following: body mass index >30 kg/m(2), diagnosed hypertension, or diagnosed dyslipidemia. A subsample with physician-reported data (n =841) was further classified with measured hypertension and dyslipidemia. Weight distribution included normal (21%), overweight (42%), and obese (37%). A 20% increased odds of CHD was estimated for every 5-kg/m(2) body mass index increase (P=.0001). MS was associated with a more than 2-fold higher risk of CHD compared with T2DM without MS (P<.0001, multivariate-adjusted [both samples]). With MS stratified by high-density lipoprotein cholesterol (<1.5 vs > or =1.5 mmol/L), compared with no MS, the odds ratio for CHD was 2.8 (normal-level high-density lipoprotein MS; 95% confidence interval, 1.8-4.5) and 1.5 (high-level high-density lipoprotein MS; 95% confidence interval, 0.8-2.9). The authors suggest that obesity alone--and particularly when the MS is present--increases CHD risk in patients with T2DM. High levels of high-density lipoprotein may modify this relationship.
Hillier
Teresa A
TA
Institut National de la Santé et de la Recherche Médicale U258-IFR69, University Paris XI, Villejuif, France. teresa.hillier@kpchr.org
Fosse
Sandrine
S
Balkau
Beverley
B
Simon
Dominique
D
Eschwège
Eveline
E
Fagot-Campagna
Anne
A
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
D008076:Cholesterol, HDL