Alawdi Shawqi H, Al-Dholae Mohammed, Al-Shawky Salah
Department of Pharmacology, Faculty of Pharmacy, Syrian Private University (SPU), Damascus, Syria.
Department of Pharmacology, Faculty of Medicine, Thamar University, Dhamar, Yemen.
Front Clin Diabetes Healthc. 2024 May 23;5:1380244. doi: 10.3389/fcdhc.2024.1380244. eCollection 2024.
Metabolic syndrome is a group of metabolic abnormalities that increase predisposition to several diseases including ischemic heart disease and diabetes mellitus. The study aimed to investigate metabolic syndrome among patients with type-2 diabetes mellitus (DM), and its impact on pharmacotherapy outcomes.
An observational cross-sectional study was performed on 910 patients with type-2 DM between June and December 2023. Fasting blood sugar, triglycerides, high-density lipoproteins (HDL), blood pressure, and abdominal obesity were measured. Metabolic syndrome was identified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Pharmacotherapy outcomes were assessed according to American Association of Clinical Endocrinologists and American Diabetes Association guidelines using the ability to achieve adequate glycemic control and normal levels of blood pressure and fasting plasma lipoproteins.
In total, 87.5% of type-2 DM patients had metabolic syndrome; the prevalence increased with age and was higher among females. Metabolic syndrome showed the following distribution of risk factors: insulin resistance (100%), low HDL (95.3%), elevated blood pressure (83%), triglycerides dyslipidemia (80.1%), and abdominal obesity (62.5%). Majority of the patients had either 5 or 4 risk factors of metabolic syndrome. The most common comorbidities were dyslipidemia (97.7%) and hypertension (83%). Treatment outcomes were insufficient where adequate glycemic control was only achieved in 12% of type-2 DM patients, and proper management of comorbid dyslipidemia and hypertension was achieved in 29% and 40.9% of patients, respectively. Adequate blood pressure control was less achieved in patients with metabolic syndrome (34.4%) than those without metabolic syndrome (77.2%). Similarly, dyslipidemia was less controlled in patients with metabolic syndrome (26.9%) than in those without metabolic syndrome (47.3%).
Pharmacotherapy outcomes were inadequate for most patients with type-2 diabetes mellitus. Adopting early preventive and therapeutic interventions for metabolic syndrome is advised to improve treatment outcomes of the comorbid dyslipidemia and hypertension.
代谢综合征是一组代谢异常，会增加患包括缺血性心脏病和糖尿病在内的多种疾病的易感性。本研究旨在调查2型糖尿病（DM）患者中的代谢综合征及其对药物治疗效果的影响。
于2023年6月至12月对910例2型糖尿病患者进行了一项观察性横断面研究。测量空腹血糖、甘油三酯、高密度脂蛋白（HDL）、血压和腹型肥胖。根据美国国家胆固醇教育计划成人治疗小组第三次报告的标准确定代谢综合征。根据美国临床内分泌医师协会和美国糖尿病协会的指南，通过实现充分血糖控制以及血压和空腹血浆脂蛋白水平正常化的能力来评估药物治疗效果。
总体而言，87.5%的2型糖尿病患者患有代谢综合征；患病率随年龄增长而增加，女性患病率更高。代谢综合征呈现以下危险因素分布：胰岛素抵抗（100%）、HDL低（95.3%）、血压升高（83%）、甘油三酯血脂异常（80.1%）和腹型肥胖（62.5%）。大多数患者有5个或则4个代谢综合征危险因素。最常见的合并症是血脂异常（97.7%）和高血压（83%）。治疗效果不佳，只有12%的2型糖尿病患者实现了充分的血糖控制，分别有29%和40.9%的患者对合并的血脂异常和高血压进行了适当管理。代谢综合征患者（34.4%）的血压控制情况不如无代谢综合征患者（77.2%）。同样，代谢综合征患者（26.9%）的血脂异常控制情况不如无代谢综合征患者（47.3%）。
大多数2型糖尿病患者的药物治疗效果不佳。建议对代谢综合征采取早期预防和治疗干预措施，以改善合并的血脂异常和高血压的治疗效果。
