Endocrine Abstracts

Background: Diabetic nephropathy (DN) represents the leading cause of end-stage renal disease (ESRD). It is known that patients with ESRD have the highest risk of cardiac morbidity and mortality. Thus, identifying and treating risk factors associated with cardio-vascular disease in diabetes may offer the best approach for preventing and delaying adverse renal and cardiovascular outcomes.

Aim: To determine the relationships between metabolic syndrome (MS), diabetic nephropathy (DN) and renal function in type 2 diabetes mellitus (DM).

Methods: In our clinic-based cohort study were enrolled 374 type 2 diabetic patients, from which 52% males and 48% females, with a mean age 58±10 years. We analysed MS, detected DN and estimated glomerular filtration rate (eGFR) during a 4 years period.

Results: Prevalence of both microalbuminuria and macroalbuminuria were higher in subjects with MS, increasing proportionally with the number of MS components. eGFR was lower in subjects with MS than in those without (89±18 vs 91±20 ml/min per 1.73 m²; P<0.001). The lowest eGFR values were found in those with four or more components of MS. Prevalence of low eGFR increased with the stage of DN and was affected by MS only in normoalbuminuric patients. The most important result was that MS was independently associated with DN, but not with low eGFR, after adjustment for all of the individual components of the MS.

Conclusions: In this study we have noted an independent association between MS and DN. This is a strong argument for treating the MS by an intensive multifactorial therapy, in order to prevent the progression of DN to the renal failure.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.