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KMID : 0927720090100030196
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Korean Clinical Diabetes
2009 Volume.10 No. 3 p.196 ~ p.203
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Cardiovascular Risk according to the Components of Metabolic Syndrome in Type 2 Diabetes
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Lim Dong-Mee
Park Keun-Young
Kim Byung-Joon
Lee Kang-Woo
Lee Myung-Jun
Yom Yoon-Shick
Koh Gwan-Pyo
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Abstract
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The metabolic syndrome (MetS) is a constellation of interrelated risk factors to promote the development of atherosclerotic cardiovascular disease (CVD). In type 2 diabetes mellitus (T2DM), however, it has not yet been clarified whether the identification of the MetS improves the prediction of cardiovascular (CV) events. Framingham risk score (FRS) is an established predicting model for CVD. In the present study, we compared the impact of MetS with FRS on CV predictors in patients with T2DM. Seventy eight patients with T2DM (29 males and 49 females) were enrolled. Patients with history of CVD, any inflammatory disease and anti-hyperlipidemic medication were excluded. MetS was defined by modified NCEP-ATP III criteria. High-sensitivity C-reactive protein (hsCRP), homocysteine, lipoprotein(a), fibrinogen, uric acid and γ-glutamy transferase were regarded as CV predictors. 71.8% of total patients had the MetS. Diabetic patients with or
without MetS were well matched in terms of the levels of all CV predictors. The CV factors were also not significantly different between numbers (1, 2, 3, 4 and 5) of components of the MetS. However, homocysteine (r = 0.317; P < 0.05), fibrinogen (r = 0.332; P <0.05) and uric acid (r = 0.268; P <0.05) levels were positively correlated with FRS. The levels of homocysteine (6.6 ± 1.7, 11.0 ± 3.7, 10.2 ± 3.7, 14.0 ± 6.1 and 11.3 ± 2.9 mmol/L; P < 0.001) and uric acid (3.2 ± 0.5, 4.6 ± 1.5, 5.4 ± 2.3, 7.1 ± 3.9 and 5.2 ± 2.2 mg/dL; P < 0.05) were significantly different to increasing quintiles of FRS. It suggests that categorizing type 2 diabetic subjects as having or not having the MetS does not provide further prediction of CVD. Collectively, these results suggest that the prediction of CVD was not related to the possession of the MetS in categorizing type 2 diabetic patients.
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KEYWORD
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Coronary disease, Diabetes mellitus, Metabolic syndrome
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