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Metabolic syndrome does not modify CVD mortality risk in Type 2 diabetes
3 July 2009
MedWire News: Metabolic syndrome is not associated with higher cardiovascular disease (CVD) mortality risk in men with diabetes, whereas diabetes substantially increases CVD mortality risk in men with the metabolic syndrome, report researchers in the journal Diabetes Care.
Both diabetes and the metabolic syndrome are associated with an increased risk for premature death, heart disease, and stroke.
As at least two-thirds of individuals with diabetes also have the metabolic syndrome, Timothy Church (Pennington Biomedical Research Center, Baton Rouge, USA) and colleagues examined the effect of the combination of metabolic syndrome and diabetes on CVD risk.
They studied a cohort of men who completed a preventive medical examination between 1979 and 2002 as part of the Aerobics Center Longitudinal Study. From a population of 34,179 individuals, 23,770 were categorized as having neither diabetes nor metabolic syndrome, 8780 as having metabolic syndrome only, 532 diabetes only, and 1097 having both conditions.
Individuals were followed for 14.6 years, during which time there were a total of 1085 CVD deaths.
Compared with men free from metabolic syndrome and diabetes, those with diabetes but not metabolic syndrome had an approximately three-fold increase in CVD mortality. Meanwhile men with metabolic syndrome but not diabetes had a 1.8-fold increase in CVD mortality, and those with both diabetes and metabolic syndrome had 3.4-fold higher CVD mortality than men with neither condition.
A subanalysis restricted to men with diabetes found no increased CVD mortality among those who had concurrent metabolic syndrome compared with those who did not. In contrast, the presence of diabetes was associated with a two-fold increased CVD mortality risk in individuals with metabolic syndrome.
The authors caution that data on duration of diabetes were not available, and this may be an important factor in the association between diabetes and CVD mortality. However, strengths of the study include the large sample size and long duration of follow-up.
“Our findings support the hypothesis that in individuals with diabetes, physicians should be aggressive in using CVD risk–reducing therapies in all patients regardless of metabolic syndrome status,” conclude the authors.
