Metabolic Syndrome in Type 1 Diabetes

Association with diabetic nephropathy and glycemic control (the FinnDiane study)

  1. Lena M. Thorn, MD12,
  2. Carol Forsblom, MD, DMSC12,
  3. Johan Fagerudd, MD, DMSC12,
  4. Merlin C. Thomas, MD, PHD3,
  5. Kim Pettersson-Fernholm, MD, DMSC12,
  6. Markku Saraheimo, MD12,
  7. Johan Wadén, MD12,
  8. Mats Rönnback, MD12,
  9. Milla Rosengård-Bärlund, MD12,
  10. Clas-Göran af Björkesten, MD12,
  11. Marja-Riitta Taskinen, MD, DMSC4,
  12. Per-Henrik Groop, MD, DMSC12 and
  13. on behalf of the FinnDiane Study Group
  1. 1Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland
  2. 2Department of Medicine, Division of Nephrology, Helsinki University Hospital, Helsinki, Finland
  3. 3Baker Research Institute, Melbourne, Australia
  4. 4Department of Medicine, Division of Cardiology, Helsinki University Hospital, Helsinki, Finland
  1. Address correspondence and reprint requests to Per-Henrik Groop, MD, DMSc, Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, POB 63, FIN-00014, Helsinki, Finland. E-mail: per-henrik.groop{at}helsinki.fi

Abstract

OBJECTIVE—The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control.

RESEARCH DESIGN AND METHODS—In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5%), intermediate (7.5–9.0%), or poor (>9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula.

RESULTS—The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89–4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance.

CONCLUSIONS—The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.

Footnotes

  • M-R.T. has received honoraria and consulting fees from Merck Sharp and Dome, Pfizer, Laboratoires Fournier, GlaxoSmithKline, and Bristol-Myers Squibb and research support from Laboratoires Fournier, Amylin, and Novartis.

    A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted May 2, 2005.
    • Received February 11, 2005.
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  1. doi: 10.2337/diacare.28.8.2019 Diabetes Care August 2005 vol. 28 no. 8 2019-2024
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