Uribe-Wiechers Ana Cecilia, Janka-Zires Marcela, Almeda-Valdés Paloma, López-Gutiérrez Joel, Gómez-Pérez Francisco J
Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., México.
Rev Invest Clin. 2015 Jul-Aug;67(4):266-72.
The development of metabolic syndrome has been described in patients with type 1 diabetes mellitus as the disease progresses over time. The purpose of this study is to assess the relationship between metabolic syndrome, albuminuria, and glomerular filtration rate, as well as to determine the prevalence of metabolic syndrome, in a group of Mexican patients with type 1 diabetes mellitus.
We conducted a cross-sectional study that included patients with type 1 diabetes mellitus who were diagnosed over 10 years ago and who are seen at the Diabetes Intensive Control Clinic of the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran in Mexico City. The presence of metabolic syndrome was determined by using the National Cholesterol Education Program-Adult Treatment Panel III (ATP III) criteria.
A total of 81 individuals were studied. The prevalence of metabolic syndrome was 18.5% (n = 15). A higher albuminuria was found in subjects with metabolic syndrome (34.9 mg/24 hours; 8.3-169.3) than in those without metabolic syndrome (9.0 mg/24 hours; 5.0-27.0; p = 0.02). Glomerular filtration rate was lower in patients with metabolic syndrome (95.3 ml/minute; [64.9-107.2] vs. 110.2 ml/minute [88.1-120.3]; p = 0.04). After classifying the population according to the number of metabolic syndrome criteria, a progressive increase in albuminuria and a progressive decrease in glomerular filtration rate were found with each additional metabolic syndrome criterion (p = 0.008 and p = 0.032, respectively). After adjusting for age, time from diagnosis, systolic blood pressure, triglycerides, HDL-cholesterol, and treatment with angiotensin receptor blockers or angiotensin converting enzyme inhibitors, we found that age, time from diagnosis, triglycerides, and HDL-cholesterol were independent factors associated with glomerular filtration rate (R2 = 0.286; p < 0.001).
Metabolic syndrome was associated with a higher albuminuria and a reduction in glomerular filtration rate in patients with type 1 diabetes mellitus. Metabolic syndrome was present in 18.5% of this group of Mexican individuals with type 1 diabetes mellitus.
随着时间的推移，1型糖尿病患者会出现代谢综合征。本研究旨在评估墨西哥一组1型糖尿病患者中代谢综合征、蛋白尿和肾小球滤过率之间的关系，并确定代谢综合征的患病率。
我们进行了一项横断面研究，纳入了10多年前被诊断为1型糖尿病且在墨西哥城萨尔瓦多·苏比拉án国家医学与营养科学研究所糖尿病强化控制诊所就诊的患者。采用美国国家胆固醇教育计划成人治疗小组第三次报告（ATP III）标准来确定代谢综合征的存在。
共研究了81例个体。代谢综合征的患病率为18.5%（n = 15）。代谢综合征患者的蛋白尿水平（34.9 mg/24小时；8.3 - 169.3）高于无代谢综合征患者（9.0 mg/24小时；5.0 - 27.0；p = 0.02）。代谢综合征患者的肾小球滤过率较低（95.3 ml/分钟；[64.9 - 107.2] vs. 110.2 ml/分钟 [88.1 - 120.3]；p = 0.04）。根据代谢综合征标准的数量对人群进行分类后，每增加一项代谢综合征标准，蛋白尿呈逐渐增加趋势，肾小球滤过率呈逐渐下降趋势（分别为p = 0.008和p = 0.032）。在对年龄、诊断时间、收缩压、甘油三酯、高密度脂蛋白胆固醇以及使用血管紧张素受体阻滞剂或血管紧张素转换酶抑制剂进行校正后，我们发现年龄、诊断时间、甘油三酯和高密度脂蛋白胆固醇是与肾小球滤过率相关的独立因素（R2 = 0.286；p < 0.001）。
代谢综合征与1型糖尿病患者较高的蛋白尿水平和肾小球滤过率降低有关。在这组墨西哥1型糖尿病个体中，代谢综合征的患病率为18.5%。
