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- Title
Abdominal Obesity Determines the Cardiovascular Risk in Type 2 DM: A Cross-Sectional Study in Spain.
- Authors
Albarran, Olga Gonzalez; Lahera, Marcos; Segura, Julian; Ruilope, Luis M.; Aragón, Carmen; Segura, Raúl; Sancho, José M.
- Abstract
Obesity and Metabolic syndrome (MS) have been associated with a high incidence of cardiovascular events. The aims of the present work were 1) to evaluate the prevalence of abdominal obesity (AO) and MS in a cohort of patients with type 2 DM. 2) to assess blood pressure (BP) control rates in those sample of diabetic patients and to evaluate its association with abdominal obesity, MS and cardiovascular (CV) risk factors (RF) and CV morbidity. A cross-sectional study was performed in 20 endocrine units in Spain, in which we recruited 927 type 2 diabetic patients. MS was defined by NCEP-ATP III criteria. BP was assessed with a cuff adapted to the arm circumference, glomerular filtration rate (GFR) was estimated by MDRD equation. Mean age was 63 ± 10 years, 407 male and 520 female, with BMI= 30.5 ±5.6 Kg/m²; waist circumference (WC): 106,8±12.3 em, 96.9±12.9 cm in male and female, respectively. HbA1c=7.6 ± 1.7 Mean SBP/DBP: 151 ± 10/86 ± 4.5 mmHg. The prevalence of MS was 72.1% (95% CI 68.3- 74.6). Hypertension was the most common component of MS (75.26%), follow by obesity (54.4%) and dyslipemia (34.41%). Only 17.2% of the patients showed only type 2 DM. 44.8% of them had two components of MS and only 10% had all the components (five). In the group of hypertensive-diabetic patients (n=707), only a 8,7% presented optimal BP control (< 130/80 mmHg), a 22% showed sub optimal control (130-140/80-90 mmHg), and 73% presented BP≥140/90 mmHg. GFR<60ml/min/1.73m² was 33.6%. Diabetic patients with MS had more incidence of previous stroke (5.6% vs 0.6% p<0.05); more coronary artery disease (20% vs 10.2% P<0.001) as compared to the diabetic patients without MS. All CVRF assessed were significantly more prevalent among diabetics with AO (waist ≥88 and 102 cm, in female and male, resp.) than diabetics without AO: hypertension (81.2% vs. 66.3%) and worse BP control rate (only 4,6% had BP<130/80 mmHg vs 11.2%), MS (93% vs 56.8%) and FR<60ml/min/1.73m² (39,7% vs 19.6%) (p<0.05). Moreover, we found a correlation between abdominal obesity and the incidence of stroke, ischemic heart disease (p<0.05). The prevalence of MS and AO in our cohort of diabetic patients are very high and it is associated with a high prevalence of CVRF and CV morbidity. Hypertension is the most important component and abdominal obesity determines BP control rates.
- Subjects
SPAIN; DISEASE risk factors; CARDIOVASCULAR diseases; OBESITY; METABOLIC syndrome; TYPE 2 diabetes; PEOPLE with diabetes; HYPERTENSION
- Publication
Diabetes, 2007, Vol 56, pA595
- ISSN
0012-1797
- Publication type
Article