Abstract
BackgroundThe Metabolic syndrome (MS) consists of central obesity, glucose intolerance, hyperinsulinemia, low high density lipoproteins, high triglycerides and hypertension. Different studies have observed that MS causes microvascular complications in patients with type 2 diabetes. The aim of the study was to find out the prevalence of MS in the Indian population with type 2 diabetes mellitus in relation to gender, duration of diabetes, and to evaluate the influence of MS and its individual components on microvascular complications such as diabetic retinopathy, diabetic nephropathy and diabetic neuropathy.MethodsA population-based cross sectional survey was conducted with 1414 patients having type 2 diabetes mellitus. The International Diabetes Federation (IDF) criteria were used to identify the metabolic syndrome. Diabetic retinopathy was graded using the stereoscopic digital fundus photography. Neuropathy was assessed by measuring the vibration perception threshold through a sensitometer. Nephropathy was diagnosed by the presence of microalbuminuria in the first morning urine sample.ResultsThe age and gender adjusted prevalence of MS, using the IDF criteria, in the South Indian population was 73.3%. The prevalence was higher in women (83.3%), compared to men (65.3%). In subjects with diabetes mellitus, without and with MS, the prevalence of retinopathy was 21.3% and 16.9% (p = 0.057); prevalence of nephropathy was 20.5% and 18.0% (p = 0.296), and prevalence of neuropathy was17.2% and 19.4% (p = 0.353) respectively. Overall and in women, the clustering of MS components led to an increase in the prevalence of diabetic nephropathy. The prevalence of retinopathy and neuropathy in MS subjects, who had diabetes for < 10 years, was more in both men and women; it was more in women but not in men when the duration of diabetes varied from 11-20 years.ConclusionsThe association of MS with microangiopathies decreased with an increase in the duration of diabetes. MS behaved differently in men and women. It may need to be managed differently in the two groups.
Highlights
The Metabolic syndrome (MS) consists of central obesity, glucose intolerance, hyperinsulinemia, low high density lipoproteins, high triglycerides and hypertension
The prevalence of MS in men decreased with an increase in the duration of diabetes (67.4%, 59.7% and 39.1% in duration < 10 years, 10-20 years and > 20 years respectively, trend p = 0.002) whereas it remained almost similar in women (83.8%, 79.1% and 81.8%, trend p = 0.401)
The prevalence of increased waist circumference was 75.5%; of Duration of Diabetes Prevalence of Metabolic Syndrome (Years)
Summary
The Metabolic syndrome (MS) consists of central obesity, glucose intolerance, hyperinsulinemia, low high density lipoproteins, high triglycerides and hypertension. Different studies have observed that MS causes microvascular complications in patients with type 2 diabetes. The Metabolic Syndrome (MS) is a constellation of central obesity, glucose intolerance, hyperinsulinemia, low high density lipoproteins (HDL), high triglycerides and hypertension [1]. It is associated with a high risk of coronary heart disease (CHD) and premature mortality [2]. Terauchi et al [13] found that neither the presence of MS (as defined by the IDF guideline) nor an increased waist circumference increased the risk of micro- or macrovascular complications in Japanese patients with type 2 diabetes mellitus
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