Prevalence of Coronary Heart Disease among Non-Smokers with Type 2 Diabetes Mellitus and Metabolic Syndrome Defined By NCEPATP 111 (National Cholesterol Education Programme Adult Treatment Panel 111)

Aye M

doi:10.4172/2167-0943.1000123

Abstract

Coronary Artery Disease (CAD) incidence varies according to certain risks; patients with pre-existing cardiovascular heart disease who later develop diabetes mellitus (DM) have the greatest risk, and non-diabetic patients with CAD, diabetic patients without CAD, and patients with metabolic syndrome (MetS) the next three high risk categories. Insulin resistance, a major feature in both DM and MetS probably causes atherogenic dyslipidaemia. Objectives: (1) to determine the prevalence of MetS and DM in the study population, (2) to determine the prevalence of Coronary Artery Disease (CAD) in DM with MetS (DM+/MetS+), in DM alone (DM+/MetS-), MetS alone (Mets+/DM-) and in ‘normal’ group (DM-/MetS-), and (3) to determine the prevalence of MetS in DM patients. Results: 62.1% of the study population had MetS, 44.7% had DM, 83.6% had both MetS and DM. 18.6% had CAD. CAD was seen in 25.2% of DM+/MetS+, 19.1% of MetS+/DM-, 14.3% of DM+/MetS-, and 11.6% of MetS-/DMpatients. DM+/MetS+ group had the highest association with CAD OR= 2.19, CI (1.43-3.35), DM-/MetS- group the lowest association OR=0.45, CI (0.27-0.73), and DM+/MetS- (OR=0.69, CI (0.28-1.73) and MetS+/DM- (OR=0.94, CI (0.57- 1.58) had no significant association with CAD. Conclusion: Only DM+/MetS+ patients had a high risk of developing CAD. Risk of CAD in patients with MetS+/ DM- and DM+/MetS- was not statistically significant in multivariate analysis, while the group with neither, MS-/DM-, had the lowest risk of developing CAD.

Highlights

metabolic syndrome (MetS) is characterized clinically by a clustering of factors; abnormal blood lipids, impaired glucose tolerance, elevated blood pressure, and abdominal obesity [1,2,3,4]
Prevalence of Coronary Heart Disease among Non-Smokers with Type 2 Diabetes Mellitus and Metabolic Syndrome Defined By NCEPATP 111 (National Cholesterol Education Programme Adult Treatment Panel 111)
Only diabetes mellitus (DM)+/MetS+ patients had a high risk of developing Coronary Artery Disease (CAD)

Summary

Introduction

MetS is characterized clinically by a clustering of factors; abnormal blood lipids (low HDL-C and high triglycerides), impaired glucose tolerance, elevated blood pressure, and abdominal obesity [1,2,3,4]. It is associated with five-fold risk of type 2 DM and two-fold risk of cardiovascular disease [5,6]. The few studies that have examined the combined effect of MetS and DM on CAD risk found increased prevalence of atherosclerotic CAD in patients with either DM or Mets alone, and in individuals with concurrent DM and MetS, a significant greater prevalence compared than either factor alone. A small prospective study and the United Kingdom Prospective Diabetes Study reported that in individuals with DM, those with MetS had a higher risk of CAD mortality, but those with DM without MetS did not [18,19,20,21,22]

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Results

Conclusion