Diabetes Metab J.  2022 Jan;46(1):93-103. 10.4093/dmj.2020.0240.

Association between Metabolic Syndrome and Microvascular Complications in Chinese Adults with Type 1 Diabetes Mellitus

• Huang Q
• Yang D
• Deng H
• Liang H
• Zheng X
• Yan J
• Xu W
• Liu X
• Yao B
• Luo S
• Weng J

• KMID: 2525129
• DOI: http://doi.org/10.4093/dmj.2020.0240

Abstract

Background
Both type 1 diabetes mellitus (T1DM) and metabolic syndrome (MetS) are associated with an elevated risk of morbidity and mortality yet with increasing heterogeneity. This study primarily aimed to evaluate the prevalence of MetS among adult patients with T1DM in China and investigate its associated risk factors, and relationship with microvascular complications.
Methods
We included adult patients who had been enrolled in the Guangdong T1DM Translational Medicine Study conducted from June 2010 to June 2015. MetS was defined according to the updated National Cholesterol Education Program criterion. Logistic regression models were used to estimate the odds ratio (OR) for the association between MetS and the risk of diabetic kidney disease (DKD) and diabetic retinopathy (DR).
Results
Among the 569 eligible patients enrolled, the prevalence of MetS was 15.1%. While female gender, longer diabetes duration, higher body mass index, and glycosylated hemoglobin A1c (HbA1c) were risk factors associated with MetS (OR, 2.86, 1.04, 1.14, and 1.23, respectively), received nutrition therapy education was a protective factor (OR, 0.46). After adjustment for gender, age, diabetes duration, HbA1c, socioeconomic and lifestyle variables, MetS status was associated with an increased risk of DKD and DR (OR, 2.14 and 3.72, respectively; both P<0.05).
Conclusion
Although the prevalence of MetS in adult patients with T1DM in China was relatively low, patients with MetS were more likely to have DKD and DR. A comprehensive management including lifestyle modification might reduce their risk of microvascular complications in adults with T1DM.

Keyword

Adult; Diabetes mellitus, type 1; Diabetic nephropathies; Diabetic retinopathy; Metabolic syndrome

Figure

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  Fig. 1. Flow chart of patient selection process. T1DM, type 1 diabetes mellitus; MetS, metabolic syndrome; TSH, thyroid-stimulating hormone.

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  Fig. 2. Receiver operating characteristics (ROC) curves of diabetes duration, body mass index (BMI) and glycosylated hemoglobin A1c (HbA1c) correlating with the presence of metabolic syndrome in adult patients with type 1 diabetes mellitus. The area under curve for BMI, HbA1c, diabetes duration, and combination of the above variable are 0.66, 0.59, 0.57, and 0.68, respectively.

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