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Exp Clin Endocrinol Diabetes 2009; 117(3): 107-112
DOI: 10.1055/s-0028-1082068
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Cardiovascular Risk Factors Characteristic for the Metabolic Syndrome in Adult Patients with Type 1 Diabetes

J. Nádas1 , Z. Putz1 , J. Fövényi2 , Z. Gaál3 , A. Gyimesi4 , T. Hídvégi5 , N. Hosszúfalusi6 , G. Neuwirth7 , T. Oroszlán8 , P. Pánczél6 , G. Széles9 , G. Vándorfi10 , G. Winkler11 , I. Wittmannl2 , G. Jermendy1
  • 1Bajcsy-Zsilinszky Hospital, Budapest
  • 2Péterfy Hospital, Budapest
  • 3Jósa Hospital, Nyíregyháza
  • 4Réthy Hospital, Békéscsaba
  • 5Petz Hospital, Gyõr
  • 6Semmelweis Medical University, Budapest
  • 7Kenézy Hospital, Debrecen
  • 8County Hospital, Zalagereszeg
  • 9Medical University, Debrecen
  • 10Cholnoky Hospital, Veszprém
  • 11Szent János Hospital, Budapest
  • 12Medical University, Pécs, Hungary
Further Information

Publication History

received 18.05.2008 first decision 27.05.2008

accepted 02.07.2008

Publication Date:
25 August 2008 (online)

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Cardiovascular Risk Factors Characteristic for the Metabolic Syndrome in Adult Patients with Type 1 DiabetesExp Clin Endocrinol Diabetes 2009; 117(03): 112-112
DOI: 10.1055/s-0030-1249167

Abstract

The prevalence rate and clinical significance of the metabolic syndrome in type 1 diabetic patients are not well established. The aim of this study was to estimate the prevalence rate of the metabolic syndrome in adult patients with type 1 diabetes. Patients with type 1 diabetes (n=533; age: 35.6±11.6 years; duration of diabetes: 18.0±11.1 years; x±SD) were consecutively enrolled from 11 diabetes outpatient departments. Data on medical history, actual treatment, anthropometric and laboratory parameters as well as actual blood pressure were registered while eating habits and physical activity were evaluated by standardized questionnaires. The prevalence rate of the metabolic syndrome according to the ATP-III criteria was 31.1% (29.7% in men, 32.7% in women; p>0.05). Using the IDF criteria a higher overall prevalence rate of the metabolic syndrome (36.2%; [32,8% in men, 39.4% in women; p>0.05]) was observed. Comparing type 1 diabetic patients to the general population, the prevalence rate of the metabolic syndrome proved to be significantly higher in each age-group of patients with type 1 diabetes. According to the stepwise logistic regression analysis the metabolic syndrome in type 1 diabetic patients was associated in a decreasing ranking order of significance with waist circumference, serum triglycerides, female gender, antihypertensive medication, HDL-cholesterol, diastolic blood pressure and serum creatinine.

Conclusions: The metabolic syndrome can frequently be detected and is predominantly associated with higher waist circumference in adult patients with type 1 diabetes in Hungary.

Key words

metabolic syndrome - type 1 diabetes - cardiovascular risk factor - waist circumference - abdominal obesity

References

  • 1 Alberti KGMM, Zimmet P, Shaw J. The metabolic syndrome – a new worldwide definition.  Lancet. 2005;  366 1059-1062
    Google Scholar
  • 2 Bonora E. The metabolic syndrome and cardiovascular disease.  Ann Med. 2006;  38 64-80
    Google Scholar
  • 3 Cockcroft D, Gault MD. Prediction of creatinine clearance from serum creatinine.  Nephron. 1976;  16 31-41
    Google Scholar
  • 4 Davis TM, Bruce DG, Davis WA. Prevalence and prognostic implications of the metabolic syndrome in community-based patients with type 1 diabetes: the Fremantle Diabetes Study.  Diabetes Res Clin Pract. 2007;  78 412-417
    Google Scholar
  • 5 DeFronzo RA, Hendler R, Simonson D. Insulin resistance is a prominent feature of insulin-dependent diabetes.  Diabetes. 1982;  31 795-801
    Google Scholar
  • 6 Després JP. Intra-abdominal obesity: an untreated risk factor for Type 2 diabetes and cardiovascular disease.  J Endocrinol Invest. 2006;  29 77-82
    Google Scholar
  • 7 Després JP, Lemieux I. Abdominal obesity and metabolic syndrome.  Nature. 2006;  444 881-887
    Google Scholar
  • 8 Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults . Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III).  JAMA. 2001;  285 2486-2497
    Google Scholar
  • 9 Ford ES. Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence.  Diabetes Care. 2005;  28 1769-1778
    Google Scholar
  • 10 Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey.  JAMA. 2002;  287 356-359
    Google Scholar
  • 11 Ford ES, Li C. Physical activity or fitness and the metabolic syndrome.  Expert Rev Cardiovasc Ther. 2006;  4 897-915
    Google Scholar
  • 12 Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge.  Clin Chem. 1972;  18 499-502
    Google Scholar
  • 13 Jermendy Gy, Hetyési K, Bíró L. et al . Prevalence of the metabolic syndrome in hypertensive and/or obese subjects.  Diabetic Med. 2004;  21 805-806
    Google Scholar
  • 14 Kahn R, Buse J, Ferrannini E. et al . The metabolic syndrome: time for a critical appraisal. Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes.  Diabetologia. 2005;  48 1684-1699
    Google Scholar
  • 15 Kilpatrick ES, Rigby AS, Atkin SL. Insulin resistance, the metabolic syndrome, and complication risk in type 1 diabetes: “double diabetes” in the Diabetes Control and Complications Trial.  Diabetes Care. 2007;  30 707-712
    Google Scholar
  • 16 Lakka HM, Laaksonen DE, Lakka TA. et al . The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men.  JAMA. 2002;  288 2709-2716
    Google Scholar
  • 17 Lorenzo C, Williams K, Hunt KJ. et al . The National Cholesterol Education Program – Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes.  Diabetes Care. 2007;  30 8-13
    Google Scholar
  • 18 Maison P, Byrne CD, Hales CN. et al . Do different dimensions of the metabolic syndrome change together over time? Evidence supporting obesity as the central feature.  Diabetes Care. 2001;  24 1758-1763
    Google Scholar
  • 19 Metascreen Writing Committee . The metabolic syndrome is a risk indicator of microvascular and macrovascular complications in diabetes. Results form Metascreen, a multicenter diabetes clinic-based survey.  Diabetes Care. 2006;  29 2701-2707
    Google Scholar
  • 20 Nádas J, Putz Zs, Jermendy Gy. et al . Public awareness of the metabolic syndrome.  Diab Res Clin Pract. 2007;  76 155-156
    Google Scholar
  • 21 Pambianco G, Costacou T, Orchard TJ. The prediction of major outcomes of type 1 diabetes: a 12-year prospective evaluation of three separate definitions of the metabolic syndrome and their components and estimated glucose disposal rate: the Pittsburgh Epidemiology of Diabetes Complications Study experience.  Diabetes Care. 2007;  30 1248-1254
    Google Scholar
  • 22 Reaven GM. The role of insulin resistance in human disease.  Diabetes. 1988;  37 1595-1607
    Google Scholar
  • 23 Reindel J, Zander E, Heinke P. et al . The metabolic syndrome in patients with type 1 diabetes mellitus: Associations with cardiovascular risk factors and cardiovascular morbidity.  Herz. 2004;  29 463-469
    Google Scholar
  • 24 Smith SC JR, Haslam D. Abdominal obesity, waist circumference and cardio-metabolic risk: awareness among primary care physicians, the general population and patients at risk – the Shape of the Nation survey.  Curr Med Res Opin. 2007;  23 29-47
    Google Scholar
  • 25 Széles G, Szigethy E, Vokó Z. et al . The epidemiology of metabolic syndrome in the Hungarian adult population: a representative survey (abstract).  Diabetes Care. 2007;  56 ((Suppl 1)) A626
    Google Scholar
  • 26 Teupe B, Bergis K. Epidemiological evidence for “double diabetes”.  Lancet. 1991;  337 361-362
    Google Scholar
  • 27 The DCCT Research Group . Weight gain associated with intensive therapy in the Diabetes Control and Complications Trial.  Diabetes Care. 1988;  11 567-573
    Google Scholar
  • 28 Thorn LM, Forsblom C, Fagerudd J. et al . Metabolic syndrome in type 1 diabetes: association with diabetic nephropathy and glycemic control (the FinnDiane study).  Diabetes Care. 2005;  28 2019-2024
    Google Scholar
  • 29 Vargane HP, Adany R. Trends of premature mortality from cardiovascular diseases in Hungary and the European Union, 1970–1997.  Orv Hetil. 2000;  141 601-607
    Google Scholar
  • 30 Yusuf S, Hawken S, Ounpuu S. et al . Obesity and the risk of myocardial infarction in 27.000 participants from 52 countries: a case-control study.  Lancet. 2005;  366 1640-1649
    Google Scholar

Notice
The original article with DOI number 10.1055/s-0028-1082088 has been corrected in accordance with the following Erratum on February 15th 2010. The correct DOI number is 10.1055/s-0028-1082068

Erratum
Please note: in this article several spelling mistakes were corrected after e-first online publication.

Correspondence

G. Jermendy

Bajcsy-Zsilinszky Teaching Hospital

Medical Department

Maglódi út 89-91

1106 Budapest

Hungary

Phone: +36/1/432 75 33

Fax: +36/1/432 75 33

Email: gyjermendy@mail.datanet.hu

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