The Relationship Between Chronic Complications And Metabolic Syndrome In Type 2 Diabetic Inpatients In Tianjin

ObjectiveTo investigate the relationship between chronic complications (macrovascular disease, microvascular disease and neuropathy) and metabolic syndrome(MS) in type 2 diabetic inpatients in Tianjin.Methods1206 type 2 diabetic patients hospitalized for the first time in Metabolic Diseases Hospital and the Third Hospital of Tianjin from 2000 to 2008 were selected. Collect demographic data (include age, sex, duration and so on) and clinical and laboratory examination (include height, weight, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, glycated hemoglobin Alc, fasting insulin, fasting C-peptide, triglyceride, total cholesterol, low-density lipoprotein, high-density lipoprotein serum uric acid and 24h urinary albumin and so on). Electrocardiogram, echocardiography, vascular ultrasound, nerval conduct velocity were measured. Diabetic retinopathy(DR) was examined through ophthalmoscope by special opthalmologists. We analysed:1. The prevalence of MS in all patients and compare differences of the prevalence of MS in different sex, different age and different diabetic duration; and the prevalence of chronic complications in all patients,2. Compare the general clinical data and lab examination data in type 2 diabetes with and without MS.3. Analyse the situation of components of MS in all type 2 diabetic inpatients, and the changes in prevalence of chronic complications with the increase of MS features.4. Compare the prevalence of chronic complications in different diabetic durations(<5 years,5-10 years,>10 years), and compare the prevalence of complications in those with and without MS of each duration group.5. Analyse the correlation of each chronic complication and MS.Results 1. The prevalence of MS:703 (58.29%) met the diagnostic criteria of MS in 1206 type 2 diabetic patients. The prevalence of MS was higher in women than in men(61.10% vs 55.83%), there is no significant difference(χ2=3.428, P=0.064). With increasing age, the prevalence of MS increased(χ2=14.808, P=0.000); With increasing duration, the prevalence of MS reduced(χ2=5.939, P=0.015).The prevalence of chronic complications was:948(78.61%) had macrovascular disease,537(44.53%) had diabetic nephropathy(DN),410(34.00%) had DR, 727(60.28%) had diabetic peripheral neuropathy(DPN).2. There was no significant difference in age, sex, duration and fasting glucose between with and without MS group in type 2 diabetic patients. Compared with non-MS group, MS group had higher body mass index, fasting insulin, fasting C-peptide, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, low-density lipoprotein, serum uric acid, C reactive protein, and had lower glycated hemoglobin Alc, high-density lipoprotein and GFR(P<0.005～0.000).3. In all components of MS, the proportion of hypertension was the highest(61.86%), next was dyslipidemia(55.72%), obesity was the lowest(53.07%). The more MS features(one/two, three, four), the higher prevalence of diabetic marcovascular diseases(69.98%,82.56%,87.84%) and DN(37.18%,43.73%,58.11%)(P<0.05), and there was no significant change in DR(33.00%,34.40%,35.13%) and DPN(58.65%,60.93%,62.16%)(P>0.05).4. With the increasing of duration(<5 years,5-10 years,>10 years), the prevalence of chronic complications increased significantly(P<0.000); in different duration groups, type 2 diabetes with MS had higher prevalence of diabetic macrovascular disease and DN than non-MS group(P<0.05), and the prevalence of DR and DPN had no significantly difference between MS and non-MS group(P> 0.05).5. Diabetic macrovascular diseases(OR=2.389, P<0.000) and DN(OR=1.675, P <0.000) were significantly associated with MS, and DR (OR=1.079,P=0.537) and DPN (OR=1.124,P=0.327) were not related with MS. .ConclusionThe more MS features, the higher prevalence of diabetic macrovascular diseases and DN, MS influenced them on the early stage of duration, and macrovascular diseases and DN were significantly associated with MS, and should give multifactorial intervention in the early stage; the prevalence of DR and DPN didn't increased with the number of MS features, and the effect MS worked on the DR and DPN was not obvious in different duration groups, DR and DPN were not related with MS.