The metabolic syndrome influences the risk of chronic complications in patients with Type II diabetes

Aims/hypothesis. We examined features of the metabolic syndrome to see if t hey modified the risk of chronic diabetic complications in patients with Ty pe II non-insulin-dependent) diabetes mellitus. Methods. A total of 85 rand omly selected patients with the metabolic syndrome (WHO definition) were co mpared with 85 Type II diabetic patients matched for age, sex, duration of diabetes, glycaemic control and without the syndrome to assess the microvas cular and macrovascular complications. Results. The patients with the metab olic syndrome had a higher prevalence of cardiovascular disease (52 vs 21 % , p < 0.001), microalbuminuria or macroalbuminuria (23 vs 7 %, p = 0.003) a nd distal neuropathy (16 vs 6 %, p = 0.048) than patients without the syndr ome. The patients with the metabolic syndrome had smaller LDL particle size 25.4 +/- 1.4 vs 26.4 +/- 1.1 nm; p < 0.001), which correlated with the rat io of se-rum triglycerides to HDL cholesterol (r = -0.64, p < 0.001). In a multiple logistic regression analysis the metabolic syndrome was associated with coronary heart disease (RR 3.84, p < 0.001) and microalbuminuria (RR 3.99, 17 = 0.0 1). Small LDL particle size was independently associated wit h neuropathy (RR 0.58, p = 0.04), whereas a high HbA1(c), was related to ne uropathy (RR 1.69, p = 0.04), retinopathy (RR 1.53, p = 0.002) and microalb uminuria (RR 1.54, p = 0.01). Conclusion/interpretation. Although chronic h yperglycaemia is the main predictor of microvascular complications in patie nts with Type II diabetes, this risk is modified by some of the components of the metabolic syndrome.