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

Abstract

O Stephen Ogedengbe,1 Ignatius U Ezeani,2 Ijezie I Chukwuonye,3 Ndukaife Anyabolu,4,5 Ikemefuna I Ozor,6 Aihanuwa Eregie1 1Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, 2Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Federal Medical Center, Umuahia, 3Division of Nephrology, Department of Internal Medicine, Federal Medical Center, Umuahia, 4Division of Nephrology, Department of Internal Medicine, Imo State University Teaching Hospital, Orlu, 5Division of Nephrology, Department of Internal Medicine, Federal Medical Centre, Owerri, 6Division of Neurosurgery, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, NigeriaBackground: The aim of this study is to evaluate the impact of coexistence of metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM) on the estimated cardiovascular risk as calculated using the United Kingdom Prospective Diabetic Study risk engine (UKPDS-RE) and also to determine the impact of the coexistence of MS and T2DM on the 10-year risk of developing coronary heart disease and stroke.Methodology: This is a cross-sectional study in which convenience sampling technique was used to recruit 124 consecutive persons with T2DM and 96 controls using a questionnaire administered technique. The World Health Organization (WHO) criterion was used to define MS and the UKPDS-RE was used to identify persons with increased risk for stroke and those with increased risk for coronary heart disease. The data obtained were analyzed using SPSS version 16. Statistical comparisons were made with chi-square for comparison of proportions. A P-value of less than 0.05 was taken as statistically significant.Results: Fifteen subjects were identified as having an increased 10-year risk for stroke and ten as having an increased risk for a coronary event. The odds of a T2DM subject with MS having an increased risk for stroke compared with a T2DM subject without MS was 0.9579≈1 while the odds of a T2DM subject with MS developing an increased risk for a coronary event compared with a T2DM subject without MS was =3.451≈3.Conclusion: MS was more common in subjects with T2DM compared with controls (irrespective of the diagnostic criteria used) and MS appears to increase the risk of a coronary event in subjects with T2DM by threefold. Also from this study, MS did not appear to cause an additional increase in the risk of stroke in subjects with T2DM.Keywords: diabetes mellitus, metabolic syndrome, coronary heart disease, cardiovascular disease, UKPDS risk engine