Aggregation Of Features Of The Metabolic Syndrome Is Associated With Increased Prevalence Of Chronic Complication In Type 2 Diabetes

Aims To investigate the association of features of the metabolic syndrome with the prevalence of chronic complication.Object A retrospective study, which includes 225 cases of clinical active T2DM patients who were hospitalized in the First Affiliated Hospital of Fujian Medical Uinversity, from June ,2004 to November, 2006. The standard of the case to be selected: Patients diagnosed with Type 2 diabetes and without insulin use during the first 5 years after diagnosis were include, Patients with serum creatinine > 177umol/L or on dialysis were excluded.Methods The 73 cases of the total 225 cases were simple T2DM, and the other 152 cases combined MS. Patients were grouped according to the number of metabolic syndrome components they presented (two, three or four; Group 2, Group 3, and Group 4, respectively ). Patients presenting only one or none of the features of metabolic syndrome were classified as not having it (Group 1). And to explore correlation between the prevalence of chronic complication of the metabolic syndrome: Diabetic retinopathy (DR), Distal sensory neuropathy (DSN), Micro-and macroalbuminuria, and cornary artery disease (CAD). And to compare and analyze age, diabetes duration, body mass index, systolic blood pressure, diastolic blood pressure, HbA1C, creatinine, High density lipoprotein cholesterol, Low density lipoprotein cholesterol, Total cholesterol, Triglycerides.Results Patients with the metabolic syndrome (68%) had a higher prevalence of diabetic retinopathy (DR) (39% vs. 18%), distal sensory neuropathy (DSN) (51% vs.37%), coronary artery disease (CAD) (44% vs.23%), micro- and macroalbuminuria (DN) (36% vs.16%), and stroke (18% vs.8%). The more metabolic syndrome features (none/one, two , three or four ), the higher the proportion of diabetes complication: DR 18%, 26%, 47%, and50%; DSN 37%, 46%, 51%, and 58%, CAD 23%, 32%, 79%, and 58%; DN 16%, 25%, and 51%; STROKE 8%, 15%, 18%, and 26%.Trends associated with the proportion of complication grouped according the number of metabolic syndrome features were analysed byχ2 for linear trends. Consequence; they are all statistically significant. DR F=17.178, P<0.01; DSN F=4.934, P=0.026; CAD F=16.206, P<0.01; DN F=12.318, P<0.01; STROKE F=5.430,P=0.02. Compare with the characteristics of Type 2 DM patients according to the clustering of metabolic syndrome features, The groups had similar age ,duration of diabetes, HbA1C. Blood pressure levels, Total cholesterol, LDL-cholesterol, Ceratinine, Plasma tyiglycerides and BMI were higher in groups with metabolic syndrome compared with the group without the syndrome. HDL-cholesterol was lower in Group 3 and Group 4(P<0.05).Conclusions The metabolic syndrome and the aggregation of its components were significantly associated with macro- and microvascular complication in Type 2 DM patients .