Endocrine Abstracts

Background: Metabolic syndrome is a cluster of conditions (abdominal obesity, atherogenic dyslipidemia, hypertension, insulin resistance with or without glucose intolerance) that occur together, increasing risk of cardiovascular diseases.

The objective: Of the study was to determine components of metabolic syndrome in patients with diabetic kidney disease (DKD) depending on the phenotype of LADA.

Methods: 42 patients with LADA (19 patients with LADA1, 23 with LADA2) and DKD were examined, as well as 25 representatives of the control group. We studied blood pressure indicators, lipid profile, HOMA-IR index and anthropometric indicators: body mass index (BMI), waist circumference (WC) and waist circumference to hip circumference ratio (WC/HC).

Results: Arterial hypertension was found in 73,7% of patients with LADA1 and 78,3% of patients with LADA2 phenotype. HOMA-IR index was higher than normal in 26,3% of LADA1 patients and 91,3% of LADA2; it was increased in patients with LADA2 phenotype by 66.8% compared to control (P<0.001) and 2.8 times compared to LADA1 (P<0.01). Hypertriglyceridemia was registered in 31.6% patients with LADA1 and 56.5% of LADA2 patients; the indicator was higher by 84% (P<0,05) and 48.1% (P<0,01) compared to control group level respectively. High-density cholesterol level was abnormal in 26.3% of LADA1 patients and 43.5% of LADA2 patients; it was lower by 19.8% (P<0.05) and 43.9% (P<0.001) respectively compared to control. Abdominal obesity was registered in 47,8% of patients with LADA2; 42,1% patients with LADA1 and 39,1% with LADA2 have metabolically unhealthy overweight phenotype. BMI in LADA2 group was 24.4% higher than the control indicator and 22.4% higher than the value in LADA1 group (P<0.001). WC was higher by 14.1% comparing LADA1/control (P<0.05), by 34.6% comparing LADA2/control (P<0.001) and by 18% in LADA2/lADA1 (P<0.01). The WC/HC ratio was the highest in the LADA2 group: by 31.3% compared to the control (P<0.001) and by 23.9% compared to the LADA1 group (P<0.01). In patients with LADA1 moderate positive relationships were found between fasting plasma glucose levels and BMI (r=0.514; P<0.05), HOMA-IR index and albumin-creatinine ratio (r=0.479; P<0.05); in LADA2 phenotype – between fasting plasma glucose and systolic blood pressure (r=0.432; P<0.05); negative correlations of medium strength – between glomerular filtration rate by the formula MDRD and BMI (r=-0.485; P<0.05) and WC/HC (r=-0.483; P<0.05).

Conclusion: The degree of insulin resistance, arterial hypertension, dyslipidemia and abdominal obesity as main components of metabolic syndrome significantly increase in patients with LADA2 phenotype which indicates the higher cardiovascular risk in this category of patients.