Metabolic Syndrome in Type 2 Diabetes Mellitus Patients: Prevalence, Risk Factors, and Associated Microvascular Complications

Asghar, S; Shahid, S; Fatima, M; Bukhari, S.M.H; Nadeem Siddiqui, S

Metabolic Syndrome in Type 2 Diabetes Mellitus Patients: Prevalence, Risk Factors, and Associated Microvascular Complications

Authors

Asghar, S

Shahid, S

Fatima, M

Bukhari, S.M.H

Nadeem Siddiqui, S

Issue Date

2023

Type

Scientific Paper

Keywords

Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Endocrinology

Abstract

Abstract Background The chronic macro and microvascular complications of diabetes mellitus pose serious health challenges. Metabolic syndrome (MetSy) is characterized by central obesity, glucose intolerance, hyperinsulinemia, low high-density lipoproteins (HDLs), high triglycerides (TGs), and hypertension. MetSy precedes or accompanies diabetes, and it has been linked to an increased risk of cardiovascular disease and premature death. This study aimed to estimate prevalence, identify risk factors, and evaluate associated microvascular complications among MetSy patients with type 2 diabetes mellitus (T2DM). Methodology Over the period of March 20, 2022, to March 31, 2023, a prospective cohort study was conducted at the Outdoor Clinic and Medicine Department of Sheikh Zayed Hospital, Rahim Yar Khan. Based on the International Diabetes Federation MetSy criteria, a total of 160 patients fulfilling the inclusion criteria were selected. A special proforma was used to obtain sociodemographic, clinical, and laboratory variables of MetSy in diabetic participants. Blood pressure and anthropometric measurements such as waist circumference (WC) and body mass index (BMI) were measured. Fasting venous blood was collected to analyze biochemical variables such as fasting blood sugar (FBS), TG, and high-density lipoprotein-cholesterol (HDL-C). The microvascular complications of T2DM were established using fundus ophthalmoscopy and neurological and kidney function assessments with the help of laboratory tests. These variables were matched between MetSy and no MetSy groups along with the presence or absence of diabetes microvascular complications. This information was analyzed based on these assessments and patient interviews. Results Of the 160 T2DM patients, the mean age was 52 years with a predominance of females (51.8%) in the 50-59-year age group (56.8%). The average BMI for females was 29.38 ± 0.54 kg/m², and 32 (20%) had obesity. Females exhibited a large WC of 93.52 ± 1.58 cm, and 48 of 83 females had reported diabetes microvascular complications. A significant p-value was observed for hypertension, high TG, low HDL-C, large WC, obesity, BMI, age, and female gender on comparing diabetics with metabolic syndrome (MetSy+) and those without metabolic syndrome (MetSy-). The prevalence of microvascular complications in T2DM patients with MetSy+ was 52.5% compared with 47.5% in MetSy-. The prevalence of diabetic retinopathy was 24.9% (95% confidence interval (CI) = 20.3%-29.6%), nephropathy was 16.8% (95% CI = 12.8%-20.7%), and neuropathy was 10.8% (95% CI = 7.4%-13.3%). Conclusions The prevalence of MetSy observed among T2DM patients was 65%, with married obese females in the 50-59-year age group being more likely to be affected than males. Hypertension, poor glycemic control, high TG, low HDL-C, and greater anthropometric waist measurements and BMI were additional risk factors that tended to increase the MetSy burden in T2DM. Diabetic retinopathy, nephropathy, and neuropathy were the most prevalent microvascular complications of diabetes, and immediate attention is needed to stop their detrimental effects. Longer uncontrolled diabetes, increasing age, and hypertension were independent predictors of microvascular complications. To further reduce the risks of complications that threaten healthy aging and prognosis for these patients, MetSy screening, health education, and better diabetic management are crucial. Keywords: abdominal obesity; body mass index (bmi); diabetic nephropathy; diabetic neuropathy; diabetic retinopathy; high-density lipoprotein-cholesterol (hdl-c); hypertension; hypertriglyceridemia (tg); metabolic syndrome (metsy); type 2 diabetes mellitus (t2dm). Copyright © 2023, Asghar et al. PubMed Disclaimer Conflict of interest statement The authors have declared that no competing interests exist. Figures Figure 1 Figure 1. The prevalence of diabetes microvascular… Similar articles Prevalence of Metabolic Syndrome and Its Risk Factors Influence on Microvascular Complications in Patients With Type 1 and Type 2 Diabetes Mellitus. Riaz A, Asghar S, Shahid S, Tanvir H, Ejaz MH, Akram M. Cureus. 2024 Mar 4;16(3):e55478. doi: 10.7759/cureus.55478. eCollection 2024 Mar. PMID: 38571859 Free PMC article. Microalbuminuria as the Tip of Iceberg in Type 2 Diabetes Mellitus: Prevalence, Risk Factors, and Associated Diabetic Complications. Asghar S, Asghar S, Mahmood T, Bukhari SMH, Mumtaz MH, Rasheed A. Cureus. 2023 Aug 9;15(8):e43190. doi: 10.7759/cureus.43190. eCollection 2023 Aug. PMID: 37692611 Free PMC article. Visceral Adiposity Index in Type 2 Diabetes Mellitus (DM) and Its Correlation With Microvascular Complications. Hulkoti V, Acharya S, Shukla S, Kumar S, Kabra R, Dubey A, Lahane V, Giri A. Cureus. 2022 Nov 9;14(11):e31279. doi: 10.7759/cureus.31279. eCollection 2022 Nov. PMID: 36523689 Free PMC article. Microvascular Complications of Type 2 Diabetes Mellitus. Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Curr Vasc Pharmacol. 2020;18(2):117-124. doi: 10.2174/1570161117666190502103733. PMID: 31057114 Review. Cardiometabolic Risk Factors Associated With Type 2 Diabetes Mellitus: A Mechanistic Insight. Chakraborty S, Verma A, Garg R, Singh J, Verma H. Clin Med Insights Endocrinol Diabetes. 2023 Dec 25;16:11795514231220780. doi: 10.1177/11795514231220780. eCollection 2023. PMID: 38148756 Free PMC article. Review. See all similar articles Cited by Prevalence of Metabolic Syndrome and Its Risk Factors Influence on Microvascular Complications in Patients With Type 1 and Type 2 Diabetes Mellitus. Riaz A, Asghar S, Shahid S, Tanvir H, Ejaz MH, Akram M. Cureus. 2024 Mar 4;16(3):e55478. doi: 10.7759/cureus.55478. eCollection 2024 Mar. PMID: 38571859 Free PMC article. A retrospective cohort study of clinical characteristics and outcomes of type 2 diabetic patients with kidney disease. He X, Deng Y, Tian B, Zhao Y, Han M, Cai Y. PeerJ. 2024 Feb 19;12:e16915. doi: 10.7717/peerj.16915. eCollection 2024. PMID: 38390389 Free PMC article. Cerebral Haemodynamic Changes in Type 2 Diabetes Mellitus Following a Three-Month Yoga Intervention: A Randomized Controlled Trial. Vidyashree M, Deepeshwar S, K MN, Kaligal C, Kanthi A, Krishna D, Raghuram N, Bathala L, Sharma VK. Cureus. 2024 Jan 2;16(1):e51548. doi: 10.7759/cureus.51548. eCollection 2024 Jan. PMID: 38313913 Free PMC article. Evaluation of Self-Management Behaviors and Its Correlation with the Metabolic Syndrome among the Type 2 Diabetes Mellitus Patients of Northern Saudi Arabia. Alsaidan AA, Thirunavukkarasu A, Alhassan HH, Bin Ahmed IA, Alnasiri AS, Alhirsan WM, Alazmi NNM, Alkhlaf AK, Alderbas JM, Alkhaldi MA. J Clin Med. 2023 Dec 25;13(1):118. doi: 10.3390/jcm13010118. PMID: 38202125 Free PMC article. References International Diabetes Federation. Brussels, Belgium: International Diabetes Federation; 2021. IDF Diabetes Atlas 10th Edition. The metabolic syndrome. Eckel RH, Alberti KG, Grundy SM, Zimmet PZ. Lancet. 2010;375:181–183. - PubMed Prevalence of metabolic syndrome in type 2 diabetes mellitus patients. Nsiah K, Shang VO, Boateng KA, Mensah FO. Int J Appl Basic Med Res. 2015;5:133–138. - PMC - PubMed Metabolic syndrome in type 2 diabetic patients: a review of current evidence. Regufe VM, Pinto CM, Perez PM. Porto Biomed J. 2020;5:0. - PMC - PubMed Association between metabolic syndrome and microvascular and macrovascular disease in type 2 diabetic mellitus. Lee MY, Hsiao PJ, Huang JC, Hsu WH, Chen SC, Shin SJ. Am J Med Sci. 2018;355:342–349. - PubMed Show all 30 references Related information MedGen LinkOut - more resources Full Text Sources Europe PubMed Central PubMed Central Miscellaneous NCI CPTAC Assay Portal

Citation

Asghar S, Asghar S, Shahid S, Fatima M, Bukhari SMH, Nadeem Siddiqui S. Metabolic Syndrome in Type 2 Diabetes Mellitus Patients: Prevalence, Risk Factors, and Associated Microvascular Complications. Cureus. 2023 May 16;15(5):e39076. doi: 10.7759/cureus.39076. PMID: 37323312; PMCID: PMC10268561.