Metabolic Syndrome as a Cardiovascular Risk Factor in Patients With Type 2 Diabetes

• Published in: Revista española de cardiologia 2004-06, Vol.57 (6), p.507-513
• Main Authors: Gimeno Orna, José A., Lou Arnal, Luis M., Molinero Herguedas, Edmundo, Boned Julián, Beatriz, Portilla Córdoba, Desirée P.
• Format: Article
• Language: eng ; spa
• Subjects: Aged; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cohort Studies; Coronary heart disease; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Enfermedad coronaria; Female; Humans; Incidence; Male; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Prevalence; Prospective Studies; Risk Factors; Síndrome X; X syndrome
• ISSN: 1885-5857; 0300-8932; 1885-5857
• DOI: 10.1016/S1885-5857(06)60626-9

To assess the cardiovascular risk associated with the presence of metabolic syndrome in patients with type 2 diabetes. Prospective cohort study of patients with type 2 diabetes. The baseline presence of components of metabolic syndrome as defined by the World Health Organization was determined. The main dependent variable was a combination of coronary events (onset angina, fatal, or nonfatal myocardial infarction) and cerebrovascular events (transient ischemic attack, fatal or nonfatal stroke, and lower limb amputation). Secondary end points were coronary events and stroke. We calculated the predictive power of the presence of metabolic syndrome and of different numbers of its component features. 318 patients were included. Mean duration of follow-up was 4.6 years (SD 1.5 years). The prevalence of metabolic syndrome was 77.0%. The rates of cardiovascular events, coronary events and stroke, expressed per 1000 patient-years, were 14.0, 5.6, and 8.4 respectively in patients without metabolic syndrome, and 33.3, 20.7, and 11.7 respectively in patients with metabolic syndrome ( P=.058 cardiovascular events; P=.05 coronary events). In the multivariate analysis, the simultaneous presence of all four metabolic syndrome components significantly increased the global cardiovascular disease risk (RR=5.0; 95% CI, 1.6-15.9; P=.006) and the risk of coronary heart disease (RR=7.4; 95% CI, 1.3-41.1; P=.02), but not the risk of stroke. The simultaneous presence of all 4 metabolic syndrome components is associated with an increase in the risk of cardiovascular events in patients with type 2 diabetes. Determinar la contribución del síndrome metabólico a la aparición de eventos cardio-vasculares en pacientes con diabetes tipo 2. Estudio de cohortes prospectivo con inclusión de pacientes con diabetes tipo 2. Se cons-tató la presencia inicial de componentes del síndrome metabólico según la definición de la Organización Mundial de la Salud. La variable dependiente principal fue una combinación de eventos coronarios (angina de inicio, infarto de miocardio fatal o no fatal), cerebrovasculares (accidente isquémico transitorio, accidente cerebrovascular fatal o no fatal) y amputación de extremidades inferiores; las variables secundarias fueron los eventos coronarios y cerebrovasculares por separado. Se evaluó el poder predictivo de la presencia o ausencia de síndrome metabólico y del número de sus componentes. Se incluyó a 318 pacientes. La duración media ± desviación estándar (DE) d