Association Between Metabolic Syndrome and Microvascular and Macrovascular Disease in Type 2 Diabetic Mellitus

The prevalence of metabolic syndrome (MetS) in patients with type 2 diabetes mellitus is high. The aim of this study was to investigate the association between MetS and micro- and macrovascular disease in patients with diabetes and the associated risk factors.

The study enrolled 1,986 (854 men and 1,132 women) patients with type 2 diabetes mellitus from outpatient clinics. MetS was defined according to the Adult Treatment Panel III for Asians.

Of the enrolled patients, 1,363 had MetS and 623 did not. The patients with MetS had significantly higher rates of albuminuria (40.8% vs. 21.8%, P < 0.001), retinopathy (37.9% vs. 28.6%, P < 0.001), coronary artery disease (19.4% vs. 11.6%, P < 0.001), cerebrovascular disease (5.8% vs. 3.2%, P = 0.014), and an ankle-brachial index < 0.9 or ≥ 1.3 (6.1% vs. 3.0%, P = 0.015). Moreover, there were significant trends for stepwise increases in albuminuria, retinopathy, coronary artery disease, cerebrovascular disease and peripheral artery disease corresponding to the number of MetS components (all P for trend < 0.05). Risk factors including MetS, old age, sex, wide pulse pressure, increased hemoglobin A_1c, dyslipidemia and decline renal function were associated with micro- and macrovascular disease.

MetS and the number of its components were significantly associated with micro- and macrovascular disease in the study patients with diabetes and this resulted in a higher risk of cardiovascular disease. Screening programs to allow for early detection and interventions should be established to lower the risk of cardiovascular disease.