Bianchi Cristina, Penno Giuseppe, Malloggi Lucia, Barontini Rossana, Corfini Marisa, Giovannitti Maria G, Di Cianni Graziano, Del Prato Stefano, Miccoli Roberto
Department of Endocrinology and Metabolism, Section of Diabetes and Metabolic Disease, University of Pisa, Ospedale Cisanello, Via Paradisa 2, 56126 Pisa, Italy.
Nutr Metab Cardiovasc Dis. 2008 Jan;18(1):31-8. doi: 10.1016/j.numecd.2006.07.007. Epub 2007 Apr 8.
The aims of this study were to establish the prevalence of metabolic syndrome (MS), in type 2 diabetes mellitus (DM), according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and to assess the association of MS with other cardiovascular (CV) risk factors in these patients.
A cross-sectional study was conducted in 1610 patients with type 2 DM. Glycated hemoglobin A1c (HbA1c), total cholesterol, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), uric acid, fibrinogen, creatinine, and albumin/creatinine ratios were measured. The risk of coronary heart disease (CHD) was calculated using the UKPDS Risk Engine. Seventy percent of the diabetic population met the criteria for MS; central obesity and hypertension were the most common criteria. Subjects with MS had higher levels of HbA1c, LDL-C, non-HDL-C, uric acid, and fibrinogen compared to patients without MS. Similarly, microalbuminuria and a high triglyceride (Tg)/HDL-C ratio (a marker of small LDL-C) occurred more frequently in patients with MS. When patients with no history of CHD events were considered, mean CHD risk was greater in those with, than those without, MS.
MS is highly prevalent in type 2 DM and is commonly associated with non-traditional CV risk factors. The diagnosis of MS seems to confer additional CHD risk in patients with type 2 diabetes.
本研究旨在依据美国国家胆固醇教育计划成人治疗小组第三次报告（NCEP ATP III）标准，确定2型糖尿病（DM）患者中代谢综合征（MS）的患病率，并评估这些患者中MS与其他心血管（CV）危险因素之间的关联。
对1610例2型糖尿病患者进行了一项横断面研究。测量了糖化血红蛋白A1c（HbA1c）、总胆固醇、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）、尿酸、纤维蛋白原、肌酐以及白蛋白/肌酐比值。使用英国前瞻性糖尿病研究（UKPDS）风险评估模型计算冠心病（CHD）风险。70%的糖尿病患者符合MS标准；中心性肥胖和高血压是最常见的标准。与无MS的患者相比，MS患者的HbA1c、LDL-C、非HDL-C、尿酸和纤维蛋白原水平更高。同样，微量白蛋白尿和高甘油三酯（Tg）/HDL-C比值（小LDL-C的标志物）在MS患者中更频繁出现。当考虑无CHD事件病史的患者时，有MS的患者的平均CHD风险高于无MS的患者。
MS在2型糖尿病中高度流行，且通常与非传统CV危险因素相关。MS的诊断似乎会增加2型糖尿病患者的CHD风险。
