Early vascular lesions in subjects with metabolic syndrome and prediabetes.


AIM The metabolic syndrome (MetS) is a cluster of cardiovascular risk factors, while prediabetes, identified by impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT), predicts future development of diabetes mellitus. Although MetS and prediabetes have a strong interrelation, it is unclear whether they denote the same risk for cardiovascular complications. The aim of the study was to compare overweight and obese individuals with MetS and prediabetes in terms of early carotid artery atheromatosis and renal dysfunction. METHODS A total of 524 overweight and obese (body mass index, BMI = or >27 kg/m2) adults, mean age 56.7+/-11.8 years, 264 men and 260 women, were studied. All participants underwent a thorough clinical and laboratory evaluation, including an oral glucose tolerance test. Carotid artery ultrasonography was performed and 24 h urine albumin excretion was measured. NCEP-ATP III and ADA criteria were used for the diagnosis of MetS and prediabetes. RESULTS Overall, 129 individuals (24.6%) had MetS without prediabetes and another 59 (11.3%) prediabetes without MetS. Individuals with prediabetes had lower albumin excretion (P=0.033) and more thickened common carotid intima-media in comparison to those with MetS (P=0.032). Furthermore, MetS was associated with higher C-reactive protein levels in comparison to prediabetes (P=0.05). CONCLUSIONS The MetS seems to have a more pronounced impact on early renal dysfunction than prediabetes, while the latter to early carotid artery structural changes.


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