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

ObjectiveTo investigate the relationship between metabolic syndrome and chronic complications in type 2 diabetic mellitus.MethodsA retrospective analysis 319 cases of T2DM who were hospitalized in the First Affiliated Hospital of Tian Jin Medical University from 2008 to 2009. Collect gerneral information and clinical and laboratory indices including sex, age, duration, height, weight, systolic blood pressure, diastolic blood pressure, triglyeeride, total cholesterol, fasting plasma glucose, glycated hemoglobin Alc, low-density lipoprotein, high-density lipoprotein and so on. We analysed:The prevalence of MS in all patients and the situation of components of MS in all type2 diabetic mellitus; The prevalence of MS in different sex, different age were compared; Comparing the general clinical data and lab examination data in type 2 diabetes with and without MS group and the relationship between HOMA-IR, UMA and the components of MS; we analysed the prevalence of chronic complications in all patients; the prevalence of complications(CAD,STROKE,DN,DR,DPN) in group with and without MS; Further analysed the changes in prevalence of chronic complications with the components of MS,the correlation of chronic complications and MS.Results1. The prevalence of MS:179(56.1%) patients met the diagnostic criteria of MS in 319 type 2 diabetic mellitus. In all components of MS, the proportion of hypertension was the highest(62.1%), next was obesity (53.3%), dyslipidemia was the lowest(49.8%).2.The prevalence of MS was higher in men than women (57.1%vs54.9%). but there was no significant difference(x2=0.167.P=0.683); The prevalence of MS was higher in≥50 year old patients than in <50 year old patients(56.7%vs54.7%), there was no significant difference(x2=0.104,P=0.747).3. There was no significant difference in different sex group with and without MS in type2 diabetic mellitus (x2=0.167,P=0.683). Compared with non-MS group, MS group had higher body mass index, systolic blood pressure, diastolic blood pressure, serum uric acid, triglyceride, total cholesterol, low-density lipoprotein, alanine aminotransferase, and MS group had lower high-density lipoprotein (P<0.05). As the components of MS increased, HOMA-IR (F=3.991, P<0.01) and UMA (F= 5.860, P<0.01) values were gradually increased, the difference was statistically significant.4. The prevalences of chronic complications respectively were:CAD 232(72.7%),DPN 179(56.1%),DN 106(33.2%),DR 95(29.8%),STROKE 38(11.9%).5. In all T2DM patients, the prevalences of chronic complications with MS group and non-MS group respectively were:CAD(81.6% vs 61.4%),STROKE(13.4% vs 10.0%),DN(39.1% vs 25.7%),DR(33.0% vs 25.7%),DPN(58.7% vs 52.9%),and there was a significant difference in CAD and DN (P<0.05).As the MS components increased, the prevalences of chronic complications were:CAD(52.3%,65.6%,80.2%, 83.6%),STROKE(6.8%,11.5%,10.4%,17.8%),DN(22.7%,27.1%,34.9% 45.2%),DR(18.2%,29.2%,34.0%,31.5%),DPN(54.5%,52.1%,59.4%,58.9%), and there was a significant difference in CAD and DN (P<0.05)6. Logistic regression analysis showed that:CAD (OR=2.778, P<0.05)and DN(OR=0.569, P<0.05)were significantly associated with MS, and STROKE, DR and DPN were not related with MS significantly.7.Multivariate Logistic regression analysis showed that:the risk factors for CAD were SBP, duration,age,TG; the risk factors for STROKE were age, sex, duration, SBP; the risk factors for DN were sex, BMI, SBP. FPG, duration, LDL-C; the risk factors for DR were sex,BMI,SBP,age; the risk factors for DPN were sex,BMI,SBP,TG.duration,age.Conclusion.In all components of MS, the proportion of hypertension was the highest, next high was obesity, dyslipidemia was the lowest.2. In all T2DM patients, HOMA-IR and UMA were significantly associated with the aggregation of the components of MS.3. The more componets of MS. the more chronic complications in type 2 diabetic mellitus.4. In all T2DM patients, Compared with non-MS group, MS group had higher body mass index, systolic blood pressure, diastolic blood pressure, serum uric acid, triglyceride, total cholesterol, low-density lipoprotein, alanine aminotransferase, Homeostasis Model Assessment-insulin resistance, microalbuminuria. MS group had lower high-density lipoprotein.5. CAD and DN were significantly associated with the aggregation of the components of MS.