The metabolic syndrome as a risk factor for cardiovascular disease, mortality, and progression of diabetic nephropathy in type 1 diabetes
- Lena M Thorn, MD1,2,
- Carol Forsblom, DMSc1,2,
- Johan Wadén, MD1,2,
- Markku Saraheimo, MD1,2,
- Nina Tolonen, MD1,2,
- Kustaa Hietala, MD1 and
- Per-Henrik Groop, DMSc (per-henrik.groop{at}helsinki.fi) on behalf of the FinnDiane Study Group1,2
- 1Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland
- 2Department of Medicine, Division of Nephrology, Helsinki University Hospital, Helsinki, Finland
Abstract
Objective: To assess the predictive value of the metabolic syndrome in patients with type 1 diabetes.
Research design and methods: Patients were from the prospective FinnDiane Study (n=3,783), mean age 37±12 and diabetes duration 23±12. Metabolic syndrome was defined according to WHO, NCEP, and IDF definitions. Follow-up time was 5.5 (3.7-6.7) years. Mortality data were complete, whereas morbidity data were available in 69% of the patients.
Results: The WHO definition was associated with a 2.1-fold increased risk of cardiovascular events and a 2.5-fold increased risk of cardiovascular- and diabetes-related mortality, after adjustment for traditional risk factors and diabetic nephropathy. The NCEP definition did not predict outcomes when adjusted for nephropathy, but markedly added to the risk associated with elevated albuminuria alone (P <0.001). The IDF definition did not predict outcomes.
Conclusions: The metabolic syndrome is a risk factor – beyond albuminuria -- for cardiovascular morbidity and diabetes-related mortality in type 1 diabetes.
Footnotes
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- Received November 13, 2008.
- Accepted January 18, 2009.
- Copyright © American Diabetes Association
