J Korean Diabetes > Volume 10(3); 2009 > Article
The Journal of Korean Diabetes 2009;10(3):196-203.
DOI: https://doi.org/10.4093/kcd.2009.10.3.196   
제2형 당뇨병환자에서 대사증후군의 정도에 따른 심혈관질환 위험도
임동미, 박근용, 김병준, 이강우, 이명준, 염윤식, 고관표
Cardiovascular Risk according to the Components of Metabolic Syndrome in Type 2 Diabetes
Dong Mee Lim, Keun Young Park, Byung Joon Kim, Kang Woo Lee, Myung Jun Lee, Yoon Shick Yom, Gwan Pyo Koh
Abstract
The metabolic syndrome (MetS) is a constellation of interrelated risk factors to promote the development of atherosclerotic cardiovascular disease (CVD). In type 2 diabetes mellitus (T2DM), however, it has not yet been clarified whether the identification of the MetS improves the prediction of cardiovascular (CV) events. Framingham risk score (FRS) is an established predicting model for CVD. In the present study, we compared the impact of MetS with FRS on CV predictors in patients with T2DM. Seventy eight patients with T2DM (29 males and 49 females) were enrolled. Patients with history of CVD, any inflammatory disease and anti-hyperlipidemic medication were excluded. MetS was defined by modified NCEP-ATP III criteria. High-sensitivity C-reactive protein (hsCRP), homocysteine, lipoprotein(a), fibrinogen, uric acid and γ-glutamy transferase were regarded as CV predictors. 71.8% of total patients had the MetS. Diabetic patients with or without MetS were well matched in terms of the levels of all CV predictors. The CV factors were also not significantly different between numbers (1, 2, 3, 4 and 5) of components of the MetS. However, homocysteine (r=0.317; P<0.05), fibrinogen (r=0.332; P<0.05) and uric acid (r=0.268; P<0.05) levels were positively correlated with FRS. The levels of homocysteine (6.6±1.7, 11.0±3.7, 10.2±3.7, 14.0±6.1 and 11.3±2.9 mmol/L; P<0.001) and uric acid (3.2±0.5, 4.6±1.5, 5.4±2.3, 7.1±3.9 and 5.2±2.2 mg/dL; P<0.05) were significantly different to increasing quintiles of FRS. It suggests that categorizing type 2 diabetic subjects as having or not having the MetS does not provide further prediction of CVD. Collectively, these results suggest that the prediction of CVD was not related to the possession of the MetS in categorizing type 2 diabetic patients. (Korean Clinical Diabetes J 10:196-203, 2009)
Key Words: Coronary disease, Diabetes mellitus, Metabolic syndrome


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