Prevalence and prognostic implications of the metabolic syndrome in community-based patients with type 1 diabetes: The Fremantle Diabetes Study

Abstract

To determine whether the metabolic syndrome (MS) predicts fatal outcome in type 1 diabetes, we assessed prospective data from 127 patients from the observational community-based Fremantle Diabetes Study. Causes of death were classified as cardiac or other. The mean±S.D. age of the patients was 42.0±15.7 years and 57.5% were male. MS defined by the World Health Organisation (WHO), National Cholesterol Education Program's Adult Treatment Panel (ATP) III and the International Diabetes Federation (IDF) consensus definitions was present in 44.9, 42.1 and 39.4% of patients, respectively. There were 29 deaths (22.8%) during a mean of 11.0 years of follow-up, 55% of which were cardiac. In Cox proportional hazards models incorporating all plausible contributory variables (including individual MS components), none of the definitions was independently associated with cardiac or all-cause death (p≥0.49 in each case). When component variables were removed, the WHO definition weakly predicted cardiac death (p=0.045). Microalbuminuria was a significant predictor of cardiac mortality (p≤0.001). A minority of our community-based type 1 patients had the MS and its presence did not add significant prognostic predictive value to conventional vascular risk factors.