Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2004;57:507-13 - Vol. 57 Num.06 DOI: 10.1016/S1885-5857(06)60626-9

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

José A Gimeno Orna a, Luis M Lou Arnal a, Edmundo Molinero Herguedas a, Beatriz Boned Julián b, Desirée P Portilla Córdoba a

a Sección de Medicina Interna, Hospital Comarcal de Alcañiz, Teruel, Spain.
b Sección de Bioquímica, Hospital Comarcal de Alcañiz, Teruel, Spain.

Keywords

X syndrome. Diabetes mellitus. Coronary heart disease.

Abstract

Introduction and objectives. To assess the cardiovascular risk associated with the presence of metabolic syndrome in patients with type 2 diabetes. Patients and method. 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. Results. 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. Conclusions. 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.

1885-5857/© 2004 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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