Risk factors of cardiocerebrovascular events in diabetic patients with metabolic syndrome

Abstract

Objective To investigate the risk factors of cardiocerebrovascular events in type 2 diabetic (T2DM) patients with metabolic syndrome (MS). Methods Total 376 patients with type 2 diabetes, including 258 cases with metabolic syndrome and 118 cases without metabolic syndrome, entered in community diabetes management program in 2008 and followed up for 6 years. The body mass index (BMI), blood pressure, blood lipids, fasting blood glucose, postprandial 2 h blood glucose, glycated hemoglobin (HbA1c), the incidence of liver and kidney function and other indicators were measured in a 6-month interval, the cardiovascular events were documented. Results At the end of follow-up: BMI, waist circumference, hip circumference, systolic blood pressure, postprandial blood glucose, high density lipoprotein levels of T2DM patients with MS were higher than those of T2DM patients (P<0.05). The systolic pressure, HbA1c and low density lipoprotein levels of T2DM with MS patients were decreased by 2.99 mmHg (1 mmHg=0.133 kPa), 0.43%, and 0.50 mmol/L, respectively (P<0.05); those of T2DM patients were decreased by 1.58 mmHg, 0.01% and 0.68 mmol/L, respectively (P<0.05). The incidence rate of cardiocerebrovascular events in T2DM group was 5.1%(6/118), that in T2DM with MS was 13.2%(34/258), Kaplan-Merier analysis showed that Cum Hazard rate of cardiovascular diseases between two groups was significantly different (χ2=3.877, P=0.049). The Cox survival analysis showed that the risk rate of cardiocerebrovascular events in T2DM with MS patients was 2.21 times higher (95%CI: 1.02-4.73) than diabetic group. After adjustment of gender, age, education level, metabolic syndrome, the risk was 2.31 times (95%CI: 1.01-5.28) higher than diabetic group. Conclusion The diabetic patients with metabolic syndrome increase the risk of cardiocerebrovascular events, and the management of T2DM with MS patients need to be strengthened. Key words: Cardiovascular diseases; Diabetes mellitus, type 2; Metabolic syndrome; Community health services