Prevalence and clinical profile of metabolic syndrome among type 1 diabetes mellitus patients in southern India.

AIM To assess the prevalence of metabolic syndrome (MetS) among patients with type 1 diabetes mellitus(T1DM) and to look at prevalence of diabetes complications in T1DM with and without MetS. METHODS We studied 451 T1DM patients attending a tertiary diabetes centre in Chennai, South India. T1DM was diagnosed based on absence of beta cell reserve and requirement of insulin from the time of diagnosis. Data on clinical and biochemical characteristics as well as complications details to study the prevalence were also extracted from electronic records. T1DM patients were divided into those with and without MetS[diagnosed according to the harmonizing the metabolic syndrome criteria(IDF/NHLBI/AHA/WHF/IAS/IASO)]. RESULTS The overall prevalence of MetS among T1DM was 22.2%(100/451). Patients with MetS were older, had longer diabetes duration, acanthosis nigricans, and increased serum cholesterol. In the unadjusted logistic regression analysis, retinopathy, nephropathy and neuropathy were associated with MetS. However after adjustment for age, gender, diabetes duration, HbA1C and BMI significant association was seen only between MetS and retinopathy [odds ratio (OR) 2.82, 95% CI 1.18-6.74, p = 0.020] and nephropathy [OR 4.92, 95% CI 2.59-9.33, p < 0.001]. CONCLUSION Prevalence of MetS is high among Asian Indian T1DM patients, and its presence is associated with increased risk of diabetic retinopathy and nephropathy.

[1]  V. Basevi.  Standards of Medical Care in Diabetes—2010 , 2010, Diabetes Care.

[2]  A. Goday,et al.  [Metabolic syndrome and type-1 diabetes mellitus: prevalence and associated factors]. , 2010, Revista espanola de cardiologia.

[3]  V. Mohan,et al.  Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES‐34) , 2007, Diabetes/metabolism research and reviews.

[4]  R. Ferrell,et al.  Nephropathy in type 1 diabetes: a manifestation of insulin resistance and multiple genetic susceptibilities? Further evidence from the Pittsburgh Epidemiology of Diabetes Complication Study. , 2002, Kidney international.

[5]  W. Młynarski,et al.  Abdominal obesity, metabolic syndrome in type 1 diabetic children and adolescents. , 2009, Pediatric endocrinology, diabetes, and metabolism.

[6]  S. Twigg,et al.  The metabolic syndrome in type 1 diabetes: does it exist and does it matter? , 2008, Journal of diabetes and its complications.

[7]  P. Zimmet,et al.  Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation , 1998, Diabetic medicine : a journal of the British Diabetic Association.

[8]  C. Mogensen,et al.  Predicting diabetic nephropathy in insulin-dependent patients. , 1984, The New England journal of medicine.

[9]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[10]  Efrat Shadmi,et al.  Disparities in multiple chronic conditions within populations , 2013, Journal of comorbidity.

[11]  L. Groop,et al.  Cardiovascular morbidity and mortality associated with the metabolic syndrome. , 2001, Diabetes care.

[12]  G. A. Fleming,et al.  C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve beta-cell function: report of an ADA workshop, 21-22 October 2001. , 2004, Diabetes.

[13]  U. Kabadi,et al.  Hyperinsulinemia and central adiposity: influence of chronic insulin therapy in type 1 diabetes. , 2000, Diabetes Care.

[14]  M. Rowley,et al.  Antibodies to diabetes-associated autoantigens in Indian patients with Type 1 diabetes: prevalence of anti-ICA512/IA2 and anti-SOX13. , 2001, Diabetes research and clinical practice.

[15]  J. Shaw,et al.  Metabolic syndrome—a new world‐wide definition. A Consensus Statement from the International Diabetes Federation , 2006, Diabetic medicine : a journal of the British Diabetic Association.

[16]  H. Blackburn,et al.  Cardiovascular survey methods. , 1969, Monograph series. World Health Organization.

[17]  A. Rigby,et al.  Insulin Resistance, the Metabolic Syndrome, and Complication Risk in Type 1 Diabetes , 2007, Diabetes Care.

[18]  V. Mohan,et al.  Anthropometric cut points for identification of cardiometabolic risk factors in an urban Asian Indian population. , 2007, Metabolism: clinical and experimental.

[19]  K. Bergis,et al.  Epidemiological evidence for "double diabetes" , 1991, The Lancet.

[20]  Hiram Beltrán-Sánchez,et al.  Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999-2010. , 2013, Journal of the American College of Cardiology.

[21]  M. S. Kirkman,et al.  Comment on: American Diabetes Association. Standards of Medical Care in Diabetes—2011. Diabetes Care 2011;34(Suppl. 1):S11–S61 , 2011 .

[22]  V. Mohan,et al.  Pancreatic beta cell response in insulin treated NIDDM patients limitations of a random C-peptide measurement. , 1987, Diabete & metabolisme.

[23]  Paul Zimmet,et al.  The metabolic syndrome—a new worldwide definition , 2005, The Lancet.

[24]  G. A. Fleming,et al.  Erratum: C-peptide is the appropriate outcome measure for type 1 diabetes clinical trials to preserve β-cell function: Report of an ADA workshop, 21-22 October 2001 (Diabetes (2004) 53 (250-264)) , 2004 .

[25]  V. Calcaterra,et al.  Geographic variation in the frequency of abdominal adiposity and metabolic syndrome in Italian adolescents with type 1 diabetes , 2014, Acta Diabetologica.

[26]  P A Cleary,et al.  Effect of excessive weight gain with intensive therapy of type 1 diabetes on lipid levels and blood pressure: results from the DCCT. Diabetes Control and Complications Trial. , 1998, JAMA.

[27]  P. Allhoff,et al.  San Antonio Heart Study , 1991 .

[28]  M. Hair,et al.  Metabolic syndrome in type 1 diabetes , 2010 .

[29]  J. Singleton,et al.  Idiopathic neuropathy, prediabetes and the metabolic syndrome , 2006, Journal of the Neurological Sciences.

[30]  H. Keen,et al.  MICROALBUMINURIA AS A PREDICTOR OF CLINICAL NEPHROPATHY IN INSULIN-DEPENDENT DIABETES MELLITUS , 1982, The Lancet.

[31]  A. McElduff,et al.  Diabetes Control and Complications Trial , 1993 .

[32]  J. Boer,et al.  Metabolic Syndrome Model Definitions Predicting Type 2 Diabetes and Cardiovascular Disease , 2013, Diabetes Care.

[33]  V. Mohan,et al.  Prevalence and risk factors for diabetic neuropathy in an urban south Indian population: the Chennai Urban Rural Epidemiology Study (CURES‐55) , 2008, Diabetic medicine : a journal of the British Diabetic Association.

[34]  V. Mohan,et al.  Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I. , 2005, Investigative ophthalmology & visual science.

[35]  L. Sechi,et al.  Regression of microalbuminuria in type 1 diabetes. , 2003, The New England journal of medicine.

[36]  Merlin C. Thomas,et al.  Metabolic syndrome in type 1 diabetes: association with diabetic nephropathy and glycemic control (the FinnDiane study). , 2005, Diabetes care.

[37]  S. Haffner,et al.  The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study. , 2003, Diabetes care.

[38]  J. Pedro-Botet,et al.  Síndrome metabólico y diabetes mellitus tipo 1: prevalencia y factores relacionados , 2010 .

[39]  S. Grundy,et al.  Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International As , 2009, Circulation.

[40]  N. R. Sheth,et al.  Waist circumference and waist for height percentiles in urban South Indian children aged 3–16 years , 2011, Indian pediatrics.

[41]  V. Mohan,et al.  Prevalence and Risk Factors of Diabetic Nephropathy in an Urban South Indian Population , 2007, Diabetes Care.

[42]  M. Deepa,et al.  The metabolic syndrome and dyslipidemia among Asian Indians: a population with high rates of diabetes and premature coronary artery disease. , 2007, Journal of the cardiometabolic syndrome.

[43]  M. Abbal,et al.  FACTOR-VIII COMPLEX AND ENDOTHELIAL DAMAGE , 1975, The Lancet.

[44]  V. Mohan,et al.  Prevalence of peripheral vascular disease and its association with carotid intima-media thickness and arterial stiffness in type 2 diabetes: The Chennai Urban Rural Epidemiology Study (CURES 111) , 2014, Diabetes & vascular disease research.

[45]  K. Haresh,et al.  Prevalence of Metabolic Syndrome among Malaysians using the International Diabetes Federation, National Cholesterol Education Program and Modified World Health Organization Definitions. , 2008, Malaysian journal of nutrition.