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Metabolic syndrome increases CV risk in prediabetes
Metabolic syndrome increases the risk for major cardiovascular events in Chinese adults with prediabetes, according to findings published in the Journal of Diabetes Investigation.
“Prediabetes is considered to be an increased risk factor for cardiovascular complications. Therefore, it would be more cost-effective to screen and manage the high-risk subgroups among individuals with prediabetes,” Youren Chen, MD, of the department of cardiology at Second Affiliated Hospital of Shantou University Medical College in Guangdong, China, and colleagues wrote. “In addition, prediabetes is often accompanied with the manifestation of much broader underlying disorders, including metabolic syndrome, a highly prevalent, multifaceted disease characterized by a series of abnormalities.”
Chen and colleagues conducted a prospective community-based cohort study analyzing data from 19,464 adults with prediabetes (mean age, 52 years; 14.4% women) who took part in a biennial health exam between June 2006 and October 2007 in a community in northern China. Researchers followed participants for a median of 10 years, assessing first occurrence of major CV events, including nonfatal myocardial infarction and stroke.
Within the cohort, there were 1,169 CV events, for an incidence rate of 6% (95% CI, 5.6-6.3).
The incidence rate was significantly higher for the 3,689 adults with metabolic syndrome (9%; 95% CI, 8.1-10) compared with the 15,775 adults in the population without metabolic syndrome (5.3%; 95% CI, 4.9-5.6). This was true for both stroke and MI, as participants with metabolic syndrome had incidence rates of 6.8% (95% CI, 6-7.6) and 2.5% (95% CI, 2-3), respectively, for each event, compared with rates of 4.3% (95% CI, 3.9-4.6) and 1.2% (95% CI, 1-1.3), respectively, in the non-metabolic syndrome cohort, according to researchers.
“We found that participants with [metabolic syndrome] had evidently increased risk of MI, strokes or total CV events,” the researchers wrote. “The present findings enrich the knowledge on the association between [metabolic syndrome] and adverse outcomes in the Chinese population with prediabetes, which would be helpful for easier screening of those high-risk individuals among the prediabetes population, so that they could be targeted for prevention strategies accordingly.”
When accounting for additional factors such as age, sex, smoking status, alcohol consumption, income, education, kidney injury, fatty liver, heart rate and high sensitivity C-reactive protein, participants with metabolic disease had a higher HR for major CV events (HR = 1.5; 95% CI, 1.31-1.73) compared with those without.
Based on the link they established between prediabetes and metabolic syndrome, the researchers suggest risk-stratification for such patients as well as lifestyle modifications, additional physical activity and 7% weight loss, with pharmacotherapy as a secondary treatment strategy.
“The high prevalence of both prediabetes and [metabolic syndrome] in the same individuals not only highlighted the importance of routinely evaluating prediabetes patients for [metabolic syndrome], but also showed that both conditions likely had a common metabolic soil,” the researchers wrote. “Obesity and insulin resistance are the common factors.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.