Metabolic Syndrome in Type 1 Diabetes
Author:
Thorn Lena M.12, Forsblom Carol12, Fagerudd Johan12, Thomas Merlin C.3, Pettersson-Fernholm Kim12, Saraheimo Markku12, Wadén Johan12, Rönnback Mats12, Rosengård-Bärlund Milla12, Björkesten Clas-Göran af12, Taskinen Marja-Riitta4, Groop Per-Henrik12,
Affiliation:
1. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland 2. Department of Medicine, Division of Nephrology, Helsinki University Hospital, Helsinki, Finland 3. Baker Research Institute, Melbourne, Australia 4. Department of Medicine, Division of Cardiology, Helsinki University Hospital, Helsinki, Finland
Abstract
OBJECTIVE—The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control.
RESEARCH DESIGN AND METHODS—In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5%), intermediate (7.5–9.0%), or poor (>9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula.
RESULTS—The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89–4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance.
CONCLUSIONS—The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.
Publisher
American Diabetes Association
Subject
Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine
Reference34 articles.
1. Isomaa B, Almgren P, Tuomi T, Forsén B, Lahti K, Nissen M, Taskinen M-R, Groop L: Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24: 683–689, 2001 2. Lakka H-M, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 288: 2709–2716, 2002 3. Reaven GM: Banting Lecture 1988: Role of insulin resistance in human disease. Diabetes 37: 1595–1607, 1988 4. Bonora E, Targher G, Formentini G, Calcaterra F, Lombardi S, Marini F, Zenari L, Saggiani F, Poli M, Perbellini S, Raffaelli A, Gemma L, Santi L, Bonadonna RC, Muggeo M: The metabolic syndrome is an independent predictor of cardiovascular disease in type 2 diabetic subjects: prospective data from the Verona Diabetes Complications Study. Diabet Med 52–58, 2003 5. Yudkin JS: Abnormalities of coagulation and fibrinolysis in insulin resistance. Evidence for a common antecedent? Diabetes Care 22 (Suppl. 3): C25–C30, 1999
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