Journal du syndrome métabolique

Prevalence of Coronary Heart Disease among Non-Smokers with Type 2 Diabetes Mellitus and Metabolic Syndrome Defined By NCEPATP 111 (National Cholesterol Education Programme Adult Treatment Panel 111)

Abstract

Aye M, Cabot JSF and Razak MSA

Coronary Artery Disease (CAD) incidence varies according to certain risks; patients with pre-existing cardiovascular heart disease who later develop diabetes mellitus (DM) have the greatest risk, and non-diabetic patients with CAD, diabetic patients without CAD, and patients with metabolic syndrome (MetS) the next three high risk categories. Insulin resistance, a major feature in both DM and MetS probably causes atherogenic dyslipidaemia.

Objectives: (1) to determine the prevalence of MetS and DM in the study population, (2) to determine the prevalence of Coronary Artery Disease (CAD) in DM with MetS (DM+/MetS+), in DM alone (DM+/MetS-), MetS alone (Mets+/DM-) and in ‘normal’ group (DM-/MetS-), and (3) to determine the prevalence of MetS in DM patients.

Results: 62.1% of the study population had MetS, 44.7% had DM, 83.6% had both MetS and DM. 18.6% had CAD. CAD was seen in 25.2% of DM+/MetS+, 19.1% of MetS+/DM-, 14.3% of DM+/MetS-, and 11.6% of MetS-/DMpatients. DM+/MetS+ group had the highest association with CAD OR= 2.19, CI (1.43-3.35), DM-/MetS- group the lowest association OR=0.45, CI (0.27-0.73), and DM+/MetS- (OR=0.69, CI (0.28-1.73) and MetS+/DM- (OR=0.94, CI (0.57- 1.58) had no significant association with CAD.

Conclusion: Only DM+/MetS+ patients had a high risk of developing CAD. Risk of CAD in patients with MetS+/ DM- and DM+/MetS- was not statistically significant in multivariate analysis, while the group with neither, MS-/DM-, had the lowest risk of developing CAD.