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KMID : 0948320070070020047
Konyang Medical Journal
2007 Volume.7 No. 2 p.47 ~ p.53
Impacts of the Metabolic Syndrome and Framingham Risk Score On Cardiovascular Predictors in Patients with Type 2 Diabetes
Lim Dong-Mee

Park Keun-Young
Abstract
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 g-glutamy transferase were regarded as CV predictors. 71.8% of total patients had the MetS. The levels of all CV predictors were the same in diabetic patients with or without MetS. 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£¼0.05), fibrinogen (r = 0.332; p£¼0.05) and uric acid (r = 0.268; p£¼ 0.05) levels were positively correlated with FRS. The levels of homocysteine (6.57¡¾1.72, 11.0¡¾3.72, 10.2¡¾3.72, 14.0¡¾6.12 and 11.3¡¾2.93 mmol/L; p£¼0.001) and uric acid (3.15¡¾0.51, 4.57¡¾1.48, 5.35¡¾2.29, 7.06¡¾3.88 and 5.16¡¾2.15 mg/dL; p£¼0.05) were significant different to increasing quintiles of FRS. In addition, the MetS was not
related to CV predictors as well as FRS in patients with T2DM. 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.
KEYWORD
Diabetes, FRS, Metabolic syndrome, Coronary heart disease
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