Type 1 Diabetes and Metabolic Syndrome: Exploring a Complex Relationship
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Abstract
Introduction: Metabolic syndrome (MS) is responsible for the increased cardiovascular risk in patients with type 2 diabetes. Few studies have focused on MS in type 1 diabetes mellitus (T1DM).
Aim: To describe the clinical, biochemical and therapeutic characteristics of T1DM patients affected by MS.
Methods: A retrospective study was carried out. It included 36 patients, suffering from T1DM and MS, hospitalized in the Endocrinology-Diabetology Department of the Hédi Chaker University Hospital of Sfax-Tunisia, from 1997 to 2020. MS was defined according to the NCEP-ATP III criteria.
Results: The mean age of the patients was 53 years. The mean duration of diabetes was 15 years. The MS appeared after a mean duration of diabetes of 13.7 years. Hypertension was reported in 21 patients (58.3%). The mean BMI was 26 kg/m2. The mean total cholesterol level was 4.59 mmol/l ±1.18, and the mean triglycerides level was 1.67 mmol/l ±0.81. The mean HDL-cholesterol level was 0.96 mmol/l ±0.29. In the majority of cases (80%), MS was the combination of dyslipidemia, hypertension and diabetes. Therapeutically, the average dose of insulin used was 0.8 IU/kg/day. The combination of metformin was necessary in 18 cases (50%). Microvascular complications were present in all patients. The cardiovascular risk was very high in all patients.
Conclusion: The prevalence of MS during T1DM is increasing. It indicates an increased risk of micro and macrovascular complications.
Keywords:
Cardiovascular risk, Metabolic syndrome, Type 1 diabetes mellitus##plugins.themes.academic_pro.article.details##
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References
- Eckel RH. The Metabolic Syndrome. In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J, éditeurs. Harrison’s Principles of Internal Medicine [Internet]. 20e éd. New York, NY: McGraw-Hill Education; 2018 [cité 26 août 2024]. Disponible sur: accessmedicine.mhmedical.com/content.aspx?aid=1183992857
- Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 20 oct 2009;120(16):1640 5.
- Thorn LM, Forsblom C, Wadén J, Saraheimo M, Tolonen N, Hietala K, et al. Metabolic syndrome as a risk factor for cardiovascular disease, mortality, and progression of diabetic nephropathy in type 1 diabetes. Diabetes Care. mai 2009;32(5):950 2.
- Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 1 janv 2020;41(1):111 88.
- Lee AS, Twigg SM, Flack JR. Metabolic syndrome in type 1 diabetes and its association with diabetes complications. Diabet Med J Br Diabet Assoc. févr 2021;38(2):e14376.
- Gingras V, Leroux C, Fortin A, Legault L, Rabasa-Lhoret R. Predictors of cardiovascular risk among patients with type 1 diabetes: A critical analysis of the metabolic syndrome and its components. Diabetes Metab. juin 2017;43(3):217 22.
- Chillarón JJ, Flores-Le-Roux JA, Goday A, Benaiges D, Carrera MJ, Puig J, et al. [Metabolic syndrome and type-1 diabetes mellitus: prevalence and associated factors]. Rev Esp Cardiol. avr 2010;63(4):423 9.
- Thorn LM, Forsblom C, Fagerudd J, Thomas MC, Pettersson-Fernholm K, Saraheimo M, et al. Metabolic syndrome in type 1 diabetes: association with diabetic nephropathy and glycemic control (the FinnDiane study). Diabetes Care. août 2005;28(8):2019 24.
- Riaz A, Asghar S, Shahid S, Tanvir H, Ejaz MH, Akram M. Prevalence of Metabolic Syndrome and Its Risk Factors Influence on Microvascular Complications in Patients With Type 1 and Type 2 Diabetes Mellitus. Cureus. mars 2024;16(3):e55478.
- Oza C, Khadilkar V, Karguppikar M, Ladkat D, Gondhalekar K, Shah N, et al. Prevalence of metabolic syndrome and predictors of metabolic risk in Indian children, adolescents and youth with type 1 diabetes mellitus. Endocrine. mars 2022;75(3):794 803.
- Lee YB, Han K, Kim B, Jin SM, Lee SE, Jun JE, et al. High Proportion of Adult Cases and Prevalence of Metabolic Syndrome in Type 1 Diabetes Mellitus Population in Korea: A Nationwide Study. Diabetes Metab J. févr 2019;43(1):76 89.
- Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. juin 2003;24(11):987 1003.
- Huang Q, Yang D, Deng H, Liang H, Zheng X, Yan J, et al. Association between Metabolic Syndrome and Microvascular Complications in Chinese Adults with Type 1 Diabetes Mellitus. Diabetes Metab J. janv 2022;46(1):93 103.
- Hanley AJG, Karter AJ, Williams K, Festa A, D’Agostino RB, Wagenknecht LE, et al. Prediction of type 2 diabetes mellitus with alternative definitions of the metabolic syndrome: the Insulin Resistance Atherosclerosis Study. Circulation. 13 déc 2005;112(24):3713 21.