Association Between Metabolic Syndrome and Microvascular and Macrovascular Disease in Type 2 Diabetic Mellitus

Am J Med Sci. 2018 Apr;355(4):342-349. doi: 10.1016/j.amjms.2017.12.004. Epub 2017 Dec 9.

Abstract

Background: The prevalence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus is high. The aim of this study was to investigate the association between MetS and micro- and macrovascular disease in patients with diabetes and the associated risk factors.

Methods: The study enrolled 1,986 (854 men and 1,132 women) patients with type 2 diabetes mellitus from outpatient clinics. MetS was defined according to the Adult Treatment Panel III for Asians.

Results: Of the enrolled patients, 1,363 had MetS and 623 did not. The patients with MetS had significantly higher rates of albuminuria (40.8% vs. 21.8%, P < 0.001), retinopathy (37.9% vs. 28.6%, P < 0.001), coronary artery disease (19.4% vs. 11.6%, P < 0.001), cerebrovascular disease (5.8% vs. 3.2%, P = 0.014), and an ankle-brachial index < 0.9 or ≥ 1.3 (6.1% vs. 3.0%, P = 0.015). Moreover, there were significant trends for stepwise increases in albuminuria, retinopathy, coronary artery disease, cerebrovascular disease and peripheral artery disease corresponding to the number of MetS components (all P for trend < 0.05). Risk factors including MetS, old age, sex, wide pulse pressure, increased hemoglobin A1c, dyslipidemia and decline renal function were associated with micro- and macrovascular disease.

Conclusions: MetS and the number of its components were significantly associated with micro- and macrovascular disease in the study patients with diabetes and this resulted in a higher risk of cardiovascular disease. Screening programs to allow for early detection and interventions should be established to lower the risk of cardiovascular disease.

Keywords: Diabetes mellitus; Metabolic syndrome; Micro- and macrovascular disease.

MeSH terms

  • Albuminuria / epidemiology
  • Albuminuria / etiology
  • Ankle Brachial Index
  • Blood Pressure
  • Cerebrovascular Disorders / epidemiology
  • Cerebrovascular Disorders / etiology*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / etiology*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / etiology*
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Peripheral Vascular Diseases / epidemiology
  • Peripheral Vascular Diseases / etiology*
  • Prevalence