제2형 당뇨병 환자에서 대사증후군의 유병률 및 관련요인의 특징

Abstract

Background : People with insulin resistance has a higher risk of developing cardiovascular disease. This leads to the importance in diagnosing metabolic syndrome. The incidence of metabolic syndrome has increased significantly in korea because of an increased population of obese people and also the incidence of DM. There have been many studies done on the incidence of metabolic syndrome in the general population. Therefore, the authors have designed this study to identify the incidence of metabolic syndrome in patients with type 2 DM and also the associated characteristics in that population. Methods : The study included 169 adults over the age of 20(84 males and 85 females) admitted to the endocrinology department of Chosun University between Jan, 1st 2005 and May, 31st 2006. Out of the people diagnosed with type 2 DM people were excluded when any of the physical measurements (height, weight, blood pressure, abdominal circumference) and blood measurements (TG, HDL-cholesterol, fasting blood sugar) were insufficient and when the patient was taking any drugs other than anti-hypertensive agents and oral anti-diabetic agents. Obesity and the other risk factors were defined by the Asian-Pacific guideline and 2001 ATP III of NCEP, respectively. Metabolic syndrome was diagnosed when more than 3 categories were satisfied. The correlation between metabolic syndrome and the criteria was tested by Pearson correlative analysis Result : The each prevalence according to the metabolic syndrome criteria of the type 2 DM patients showed low HDL cholesterolemia with the highest incidence of 57.4 % followed by hypertriglyceridemia(52 %), obesity(37.5 %) and hypertension(33 %). The each incidence of diagnostic criteria in metabolic syndrome according to sex was different. In males, hypertriglyceridemia was the highest with the incidence of 57.7 % followed by low HDL-cholesterolemia(49.5 %), obesity(35 %) and hypertension (30 %). In women, the incidence were low HDL-cholesterolemia(64.8 %), hypertriglyceridemia(47.6 %), obesity(40 %) and hypertension(36 %), in a descending order. The analysis between the diagnosis of metabolic syndrome in type 2 DM patients and the criteria showed that hypertriglyceridemia (correlative value 0.575) had the highest correlation followed by low HDL-cholesterolemia (correlative value 0.446), obesity (correlative value 0.350) and hypertension (correlative value 0.200). All the correlations were statistically significant with a p-value less than 0.01. Conclusions : Type 2 DM is a important factor of metabolic syndrome based on insulin resistance. The control of blood glucose with prevention and early diagnosis of the other factors related to metabolic syndrome in type 2 DM is important for preventing cardiovascular complications. Especially on this study, hypertriglyceridemia is the most significant factor related to metalbolic syndrome. Therefore, it is emphasized that the management on hypertriglyceridemia in type 2 DM is the most important in preventing metabolic syndrome in this study.