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Metabolic Syndrome Classification of Little Help in Diabetics

Posted: Thursday, November 30, 2006

A diagnosis of metabolic syndrome does not appear to provide additional prognostic information in patients with type 2 diabetes.

Senior investigator Dr. Edoardo Mannucci stated, that in recent years many have "criticized the clinical value of metabolic syndrome, considering that the choice of parameters selected as diagnostic criteria, and the thresholds set for each of those components, are largely arbitrary."

To investigate the predictive utility of three or more metabolic syndrome components, Dr. Mannucci of the University of Florence and colleagues conducted an observational study involving about 4000 patients with type 2 diabetes.

They were divided into four categories. These consisted of hyperglycemia plus one other component of the metabolic syndrome, namely elevated blood pressure, hypertriglyceridemia, low HDL cholesterol and elevated waist circumference.

Within each category, there was no significant difference in mortality at a median follow-up of about 33 months in those with and without the metabolic syndrome at baseline.

For elevated blood pressure this was 7.9% versus 6.4% and for hypertriglyceridemia, 12.0% versus 10.7%. For low HDL cholesterol, corresponding values were 19.0% versus 14.0%, and for elevated waist circumference 11.9% versus 11.1%.

Even after adjustment, metabolic syndrome was not associated with increased mortality in any of the groups studied.

Give these findings, Dr. Mannucci added that the number of components needed to perform diagnosis of the metabolic syndrome -- conventionally three -- is also arbitrary.

"In diabetic patients with one or more components of metabolic syndrome other than hyperglycemia," he concluded, "the presence of further alterations does not modify long-term prognosis."

Source: Diabetes In Control: Diabetes Care Nov, 2006;29:2515-2917