There is a strong association between the metabolic syndrome and microvascular disease in people with Type 2 diabetes, Belgian researchers have shown.
Their analysis, which appears in the journal Diabetes
Michel Hermans (Université catholique de Louvain, Brussels) and team studied 738 adults with Type 2 diabetes, of whom 145 had the metabolic syndrome. Participants with and without the syndrome were well-matched with respect to age and diabetes duration.
The mean number of components of the metabolic syndrome was 1.8 in those without the syndrome versus 4.0 in those with.
Body mass index, waist circumference, relative/absolute fat mass, visceral fat, conicity, insulin resistance, triglycerides, glycated hemoglobin, systolic blood pressure, and inflammatory markers were all significantly higher in those with versus without the metabolic syndrome.
With regard to macrovascular disease, the prevalence of peripheral artery disease, coronary artery disease, and cerebrovascular disease were all higher in those with the syndrome than without, at 11 vs 7%, 26 vs 10%, and 8 vs 5%, respectively.
Furthermore, the prevalence of microvascular complications increased with increasing number of components of the metabolic syndrome.
Specifically, diabetic retinopathy affected 3% of those with one component versus 26% of those with five components. For peripheral neuropathy the values were 19% and 35%, respectively, while for albuminuria the values were 6% and 32%, respectively.
Discussing their results, Hermans and co-authors note that the association with macrovascular disease is expected “as intrinsic to the current definition of metabolic syndrome.”
By contrast, “it is much debated whether establishing the presence of a metabolic syndrome in hyperglycemic states further contributes to stratifying or predicting microvascular risk.”
They say their data “indicate a strong association between metabolic syndrome and vascular disease, with respect to both macro- and microangiography in a large, mostly Caucasian, cohort of Type 2 diabetes mellitus patients of both genders.”
However they add: “Whether these risks are cumulative, potentiating or permissive will be determined in prospective studies on the natural history of microvascular disease in relation with the serial acquisition of metabolic syndrome phenotype components.”