FREQUENCY OF METABOLIC SYNDROME IN TYPE 2 DIABETES AND ITS RELATIONSHIP WITH INSULIN RESISTANCE

Authors

  • Shahid Ahmed
  • Syed Azhar Ahmed
  • Nadir Ali

Abstract

Background: The metabolic syndrome is a cluster of various cardiovascular disease riskfactors: diabetes and pre-diabetes, abdominal obesity, hyperlipidaemia and high blood pressure.People with metabolic syndrome are twice as likely to die from and three times as likely to havea heart attack or stroke compared with people without the syndrome. The objective of the studywas to observe the frequency of metabolic syndrome (MetS) in patients with type 2 diabetesmellitus and study the relationship of insulin resistance with the metabolic syndrome and itsdifferent clinical parameters. Methods: The study was conducted at Combined MilitaryHospital, Malir, in about six months. Hundred and fifty-five patients with type 2 diabetes wereincluded in the study, who were diagnosed after 25 years of age. All those suffering from anyliver disease, non diabetic renal disease, thyroid hormonal disorder, advanced cardiac diseaseand cancers were excluded from the study. Insulin resistance was measured using homeostaticmodel assessment of insulin resistance (HOMA-IR) and International Diabetes Federation (IDF)criteria were used to diagnose metabolic syndrome. Results: Among 155 type 2 diabeticpatients, 66.5% were having metabolic syndrome (MetS) according to IDF criteria. Thisfrequency was significantly higher in women (84.7%) as compared to men (44.3%). Differenceof means of HOMA-IR (Insulin resistance) in MetS present and MetS absent cases wasstatistically significant in men (p=0.02) but not in women (p=0.57), when compared throughindependent sample t-test. Insulin resistance (HOMA-IR) was not significantly correlated withwaist circumference (r=0.24), BMI (r=0.16), triglycerides (r=0.22), HDL cholesterol (r=0.18)and HbA1c (r=0.35) but showed moderate correlation with fasting plasma glucose (r=0.44).Among 39 patients belonging to the 4th quartile of HOMA-IR, i.e., the most insulin resistantpeople, 79% patients had MetS according to IDF criteria, and 21% patients did not have MetS.Conclusion: It is concluded that the frequency of MetS is significantly high in patients withtype 2 diabetes. Insulin resistance as measured through HOMA-IR does not show significantcorrelation with clinical parameters of MetS in type 2 diabetics.Keywords: Metabolic syndrome, insulin resistance, HOMA-IR, IDF criteria

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Published

2010-06-01