ECE2008 Poster Presentations Clinical cases (60 abstracts)
University Specialized Hospital for Active Treatment in Endocrinology Acad. Iv. Penchev, Sofia, Bulgaria.
Objective: The study was to characterize metabolic syndrome (MS) in type 2 diabetic patients (T2D pts) according to the definition of International Diabetes Federation (IDF) and to test the hypothesis that this definition identifies insulin resistant subjects.
Materials and methods: Three hundred and eighty-three (194 females, 189 males) T2D pts of age 62.2±10.4 years, HbA1c 7.5±1.4%, BMI 30.8±4.8 kg/m2 (mean±S.D.) took part in the study. Fifty persons with normal glucose tolerance (NGT) of mean age 60.7±11.2 years served as a control group with regard to insulin sensitivity (IS). It was determined as a glucose metabolized (M; mg/kg per min) using a manual hyperinsulinaemic euglycaemic clamp technique and homeostasis model assessment of insulin resistance (HOMA-IR). The study was approved by Local Ethical Committee.
Results: According to the definition of IDF, MS was diagnosed in 76.5% of the T2D pts (82% females, 70.9% males). The highest percent of the MS pts (75.1%) were characterized by raised blood pressure, followed by those with reduced HDL cholesterol (63.5%), raised triglycerides (72.3%) and combined dyslipidaemia was established in 42.3% of the MS pts. IS of the MS pts M 3.238±1.673 was significantly lower compared to that of the pts with no MS (non-MS pts) M 6.893±3.846 and control group M 6.296±3.176 mg/kg per min, both P<0.001. HOMA-IR of the MS pts 6.02±1.69 was significantly higher compared to that of non-MS pts 3.07±1.27 and control group 3.54±1.92, both P<0.001.
Conclusions: The diagnostic criteria for metabolic syndrome of IDF definition are easily applicable in routine clinical practice that makes it a very useful tool for early treatment of cardiometabolic risk factors. Nevertheless that insulin resistance is not included in IDF definition, according to our data, it identifies type 2 diabetic patients with insulin resistance, as well.