Evaluating the impact of type 2 diabetes mellitus on cardiovascular risk in persons with metabolic syndrome using the UKPDS risk engine

Figures & data

Table 1 WHO diagnostic guidelines for metabolic syndrome

	WHO (1999)
Obesity	WHR
	>0.90 (male)
	>0.85 (female)
	or
	BMI >30 kg/m^2
Serum triglycerides	≥150 mg/dL
Serum HDL cholesterol	<35 mg/dL (male)
	<39 mg/dL (female)
Blood pressure	≥140/90 mmHg
Fasting plasma glucose	(Requirement)
	FPG ≥110 mg/dL
Other risk factors	Urinary albumin excretion
	rate ≥20 μg/min
	or albumin/creatinine ratio
	≥30 mg/g
Diagnosis	Impaired FPG + any 2 criteria

Abbreviations: WHR, waist-hip ratio; BMI, body mass index; FPG, fasting plasma glucose; WHO, World Health Organization; HDL, high-density lipoprotein.

Figure 1 UKPDS risk engine.

Abbreviations: CHD, coronary heart disease; HbA1c, Glycated haemoglobin; HDL Cholesterol, high density lipoprotein cholesterol; Systolic BP, systolic blood pressure.

Table 2 A comparison of the sociodemographic parameters of the two study groups

Parameters	Control n (%)	T2DM n (%)	χ^2	df	P
	N=96	N=124
Age group
30–39 years	7 (7.3)	7 (5.6)	2.107	8	0.97
40–49 years	12 (12.5)	15 (12.1)
50–59 years	32 (33.3)	45 (36.3)
60–69 years	28 (29.2)	41 (33.1)
70+ years	17 (17.7)	16 (12.9)
Sex
Male	38 (39.6)	50 (40.3)	0.017	8	0.99
Female	58 (60.4)	74 (59.7)
Level of education
No education	6 (6.3)	20 (16.1)	15.282	6	0.01*
Primary	22 (22.9)	37 (29.8)
Secondary	33 (34.4)	23 (18.5)
Tertiary	35 (36.5)	44 (35.5)
Marital status
Single	4 (4.2)	3 (2.4)	8.582	6	0.19
Married	84 (87.5)	112 (90.3)
Divorced	0 (0)	4 (3.2)
Widowed	8 (8.3)	5 (4.0)

Note:

* P<0.05 (statistically significant).

Abbreviations: T2DM, type 2 diabetes mellitus; df, degrees of freedom; n, number; N, sample size.

Table 3 Prevalence of metabolic syndrome (MS) using the WHO guideline

Parameters	Control n (%)	FDR n (%)	T2DM n (%)	χ^2	df	*P
	N=96	N=96	N=124
MS	13 (13.5)	16 (16.7)	108 (87.1)	159.2	2	0.01
No MS	83 (86.5)	80 (83.3)	16 (12.9)

Note:

* P<0.05 (statistically significant).

Abbreviations: T2DM, type 2 diabetes mellitus; WHO, World Health Organization; df, degrees of freedom; n, number; N, sample size; FDR, first degree relative.

Table 4 Means of clinical and biochemical variables in type 2 diabetes mellitus persons with and without metabolic syndrome (MS)

Parameters	MS n=108 Mean ± SD	No MS n=16 Mean ± SD	t	df	P
Age (years)	57.4±10.4	59.8±13.4	0.846	122	0.40
Waist circumference (cm)	98.10±11.9	84.81±12.4	4.132	122	0.01*
Waist-hip ratio	0.94±0.1	0.90±0.1	1.594	122	0.11
BMI (kg/m^2)	27.29±5.0	23.10±2.2	3.266	122	0.01*
Systolic blood pressure (mmHg)	137.85±17.1	126.56±9.4	2.436	122	0.01*
Diastolic blood pressure (mmHg)	86.60±9.9	78.01±6.2	3.365	122	0.01*
HbA1c (%)	7.98±1.8	6.73±1.2	2.693	122	0.01*
FBS (mg/dL)	139.710±60.9	100.33±26.7	2.543	122	0.01*
Total cholesterol (mg/dL)	184.98±47.9	170.13±41.5	1.177	122	0.24
HDL cholesterol (mg/dL)	49.04±15.8	51.19±16.8	−0.503	122	0.61
LDL cholesterol (mg/dL)	117.20±45.8	107.212±33.9	0.854	122	0.40
Triglycerides (mg/dL)	132.94±48.9	105.31±24.4	2.212	122	0.02*

Note:

* indicates P<0.05 (statistically significant).

Abbreviations: BMI, body mass index; df, degrees of freedom; FBS, fasting blood sugar; t, Student’s t-test; LDL, low-density lipoprotein; HDL, high-density lipoprotein; SD, standard deviation.

Table 5 The metabolic syndrome (MS) (WHO criteria) versus UKPDS risk for coronary event and stroke in persons living with T2DM

WHO criteria	Increased	Normal	Odds ratio*
1. UKPDS risk for coronary event
MS	10	98	3.451≈3
No MS	0	16
2. UKPDS risk for stroke
MS	13	95	0.9579≈1
No MS	2	14

Note:

* The peto’s odds ratio was used because of the cell with 0.

Abbreviations: WHO, World Health Organization; UKPDS, United Kingdom Prospective Diabetic Study; T2DM, type 2 diabetes mellitus.