[Diabetes and multimetabolic syndrome]

Area of Science:

• Cardiovascular Medicine
• Endocrinology
• Metabolic Disorders

Background:

• Metabolic syndrome links metabolic alterations (hyperglycemia, hyperlipidemia) and chronic inflammation to increased cardiovascular morbidity and mortality.
• Endothelial dysfunction, associated with insulin resistance, contributes to vascular disease progression in metabolic syndrome.
• Insulin resistance is the unifying factor in metabolic syndrome, characterized by metabolic, pressor, lipid, and obesity factors.

Purpose of the Study:

• To highlight the significant cardiovascular risk associated with metabolic syndrome.
• To discuss the role of statin therapy in mitigating cardiovascular mortality in metabolic syndrome patients.
• To address the specific dyslipidemia patterns and high cardiovascular risk in metabolic syndrome despite normal LDL cholesterol.

Main Methods:

• Review of existing literature on metabolic syndrome, cardiovascular disease, and treatment outcomes.
• Analysis of cluster studies identifying key factors of metabolic syndrome.
• Evaluation of the efficacy of statin therapy in reducing cardiovascular mortality in this patient population.

Main Results:

• Metabolic syndrome identifies substantial cardiovascular risk beyond individual risk factors.
• Statins demonstrate beneficial effects on cardiovascular mortality in metabolic syndrome.
• Risk reduction with statins is observed despite dyslipidemia characterized by high triglycerides and low HDL, not necessarily high LDL cholesterol.

Conclusions:

• Metabolic syndrome confers a significant additional cardiovascular risk.
• Statin therapy is mandatory for patients with metabolic syndrome due to their high risk of cardiovascular events, irrespective of LDL cholesterol levels.
• Targeting the specific lipid profile and underlying insulin resistance in metabolic syndrome is critical for cardiovascular risk management.