Korean Diabetes J.  2009 Oct;33(5):392-400. 10.4093/kdj.2009.33.5.392.

Relationship Between Metabolic Syndrome and Risk of Chronic Complications in Koreans with Type 2 Diabetes

• Chung HS
• Seo JA
• Kim SG
• Kim NH
• Kim DM
• Chung CH
• Choi DS

• KMID: 2231146
• DOI: http://doi.org/10.4093/kdj.2009.33.5.392

Abstract

BACKGROUND
We examined the relationships between components of metabolic syndrome at the time of diagnosis of type 2 diabetes, and the development of chronic complications in Korean patients with type 2 diabetes.
METHODS
The medical records of patients with type 2 diabetes who had undergone treatment for at least five years prior were collected from 10 general hospitals in Korea. Among a total of 1,418 patients reviewed for possible inclusion in this study, 603 patients were selected, and the occurrence of complications among these patients was evaluated.
RESULTS
Among the 603 patients (male, 253; female, 350), 154 males (60.8%) and 266 females (76.0%) were diagnosed with metabolic syndrome at the time of initial diagnosis of type 2 diabetes. The incidence of chronic complications (average follow-up 15.2 +/- 4.9 years) included 60 cases of coronary artery disease (CAD), 57 cases of cerebrovascular accident (CVA), 268 cases of diabetic retinopathy (DR), 254 cases of diabetic nephropathy (DN), and 238 cases of diabetic peripheral neuropathy (DPN). As compared to patients without metabolic syndrome, the adjusted relative risks (95% CI) of incidental diabetic complications in patients with metabolic syndrome were 3.28 (1.40~7.71) for CAD, 2.04 (0.86~4.82) for CVA, 1.53 (1.10~2.14) for DR, 1.90 (1.29~2.80) for DN, and 1.51, (1.06~2.14) for DPN. With the addition of just one constituent of metabolic syndrome, the relative risk of developing CAD, CVD, DR, DN, and DPN increased by 2.08 (95% CI, 1.27~3.40), 1.16 (0.80~1.66), 1.09 (0.93~1.26), 1.29 (1.06~1.57) and 1.06 (0.87~1.26), respectively.
CONCLUSION
Metabolic syndrome in Korean patients with type 2 diabetes increases the risk of developing both macrovascular and microvascular complications.

Keyword

Diabetes complication; Metabolic syndrome X; Type 2 diabetes mellitus

MeSH Terms

Coronary Artery Disease
Diabetes Complications
Diabetes Mellitus, Type 2
Diabetic Nephropathies
Diabetic Retinopathy
Female
Follow-Up Studies
Hospitals, General
Humans
Incidence
Korea
Male
Medical Records
Metabolic Syndrome X
NAD
Peripheral Nervous System Diseases
Stroke
NAD

Figure

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  Fig. 1 Estimated cumulative hazard ratio of Macrovascular complications in diabetic patients with and without metabolic syndrome. A. Coronary artery disease (P < 0.01). B. Cerebrovascular accident (P = 0.02).

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  Fig. 2 Estimated cumulative hazard ratio of Microvascular complications in diabetic patients with and without metabolic syndrome. A. Diabetic retinopathy (P < 0.01). B. Diabetic nephropathy (P < 0.01). C. Microalbuminuria (P < 0.01). D. Overt nephropathy (P = 0.15). E. Diabetic neuropathy (P < 0.01).

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