Impact of the metabolic syndrome on macrovascular and microvascular outcomes in type 2 diabetes mellitus: United Kingdom Prospective Diabetes Study 78.

Description

Using data from the well-known United Kingdom Prospective Diabetes Study (UKPDS), Cull et al. assessed the metabolic syndrome’s impact on both macrovascular and microvascular outcomes in 4,542 patients with type 2 diabetes followed for 10.3 years. The predictive value of the clinical criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), World Health Organization (WHO), International Diabetes Federation (IDF), and European Group for the Study of Insulin Resistance (EGIR) were compared. The relative risk of metabolic syndrome-related cardiovascular disease ranged from 1.23 (IDF) to 1.45 (WHO). Moreover, every criteria studied was significant. However, patients with type 2 diabetes with the metabolic syndrome were not at increased risk for microvascular complications when compared to patients with type 2 diabetes who did not have the metabolic syndrome. The authors concluded that the metabolic syndrome only adds value in predicting macrovascular outcomes and not microvascular disease in patients with type 2 diabetes. The authors also emphasize that the metabolic syndrome provides limited additional information in cardiovascular risk stratification with respect to type 2 diabetes.