[Microalbuminuria accounts for the increased vascular disease risk in diabetic patients with metabolic syndrome]. / La microalbuminuria explica el incremento de riesgo vascular en pacientes con diabetes y síndrome metabólico.

The aim of this study was to determine the impact of the metabolic syndrome on vascular disease risk in patients with type-2 diabetes. A prospective cohort study was carried out. The main dependent variable was the combination of coronary disease, stroke and lower leg amputation. Cox regression modeling was used. In total, 317 patients were followed for a mean of 7.7 years. The prevalence of metabolic syndrome was 87%. Multivariate analysis identified the following as predictors of incident vascular disease: age (relative risk [RR] =1.06, 95% confidence interval [CI], 1.02-1.1; P=.0003), baseline cardiovascular disease (RR=1.8; 95% CI, 1.1-3.0; P=.017), and the simultaneous presence of four metabolic risk factors (RR=5.8; 95% CI, 1.8-18; P=.003). The most predictive factor was microalbuminuria (chi2=5.9; P=.015). Microalbuminuria accounts for the increased risk of vascular disease in patients with metabolic syndrome. In evaluating vascular disease risk in patients with type-2 diabetes, it is more important to consider the total number of metabolic risk factors than the presence of metabolic syndrome alone.

La microalbuminuria explica el incremento de riesgo vascular en pacientes con diabetes y síndrome metabólico / Microalbuminuria accounts for the increased vascular disease risk in diabetic patients with metabolic syndrome

El objetivo fue evaluar la importancia pronóstica del síndrome metabólico (SM) en el riesgo vascular en diabetes mellitus tipo 2 (DM2). Se realizó estudio de cohortes prospectivo. La variable dependiente, enfermedad cardiovascular (ECV), fue una combinación de eventos coronarios, cerebrovasculares y amputación de extremidades inferiores. Se utilizó modelo de regresión de Cox. Se incluyó a 317 pacientes seguidos durante 7,7 años. La prevalencia de SM fue del 87%. Los predictores de ECV incidente en análisis multivariable fueron: edad (riesgo relativo [RR] = 1,06; intervalo de confianza [IC] del 95%, 1,02-1,1; p = 0,0003), ECV prevalente (RR = 1,8; IC del 95%, 1,1-3; p = 0,017), y presentar simultáneamente 4 factores de riesgo metabólicos (RR = 5,8; IC del 95%, 1,8-18; p = 0,003). El componente más predictivo fue la microalbuminuria (χ2 = 5,9; p = 0,015). La microalbuminuria explica el poder predictivo del SM para la aparición de ECV. Es más importante considerar el número de factores de riesgo metabólico que el SM al evaluar el riesgo vascular del paciente con DM2 (AU)

The aim of this study was to determine the impact of the metabolic syndrome on vascular disease risk in patients with type-2 diabetes. A prospective cohort study was carried out. The main dependent variable was the combination of coronary disease, stroke and lower leg amputation. Cox regression modeling was used. In total, 317 patients were followed for a mean of 7.7 years. The prevalence of metabolic syndrome was 87%. Multivariate analysis identified the following as predictors of incident vascular disease: age (relative risk [RR] =1.06, 95% confidence interval [CI], 1.02-1.1; P=.0003), baseline cardiovascular disease (RR=1.8; 95% CI, 1.1-3.0; P=.017), and the simultaneous presence of four metabolic risk factors (RR=5.8; 95% CI, 1.8-18; P=.003). The most predictive factor was microalbuminuria (χ2=5.9; P=.015). Microalbuminuria accounts for the increased risk of vascular disease in patients with metabolic syndrome. In evaluating vascular disease risk in patients with type-2 diabetes, it is more important to consider the total number of metabolic risk factors than the presence of metabolic syndrome alone (AU)