Key result
Type 2 diabetes increased average carotid IMT by 0.010 mm/year vs 0.001 mm/year in metabolic syndrome (p=0.011) and PWV by 0.162 vs -0.182 m/s/year (p=0.002) over 4 years.
Why the study?
Does type 2 diabetes accelerate the 4-year progression of vascular, renal, and cardiac target organ damage and haemodynamic parameters compared with metabolic syndrome in patients with insulin resistance?
Cohort (n=112)
The individuals performing the different tests were blinded to the clinical data
Yes
Does type 2 diabetes accelerate the 4-year progression of vascular, renal, and cardiac target organ damage and haemodynamic parameters compared with metabolic syndrome in patients with insulin resistance?
Answers are grounded in this paper and cite their sources.
Patients with type 2 diabetes experience significantly faster progression of vascular target organ damage (carotid IMT and arterial stiffness by PWV) over 4 years compared to patients with metabolic syndrome alone, whereas renal and cardiac target organ damage and augmentation indices remain stable in both groups.
OBJECTIVES: We prospectively examined the impact of type 2 diabetes compared with metabolic syndrome (MetS) on the development of vascular disease over 4 years as determined by anatomic and functional markers of vascular disease. By comparing the vascular outcomes of the 2 disorders, we seek to determine the independent effect of elevated glucose levels on vascular disease. SETTING: 2 primary care centres in Salamanca, Spain. PARTICIPANTS: We performed a prospective observational study involving 112 patients (68 with type 2 diabetes and 44 with MetS) who were followed for 4 years. PRIMARY AND SECONDARY OUTCOME MEASURES: Measurements included blood pressure, blood glucose, lipids, smoking, body mass index, waist circumference, Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hs-c-reactive protein and fibrinogen levels. We also evaluated vascular, carotid intima media thickness (IMT), pulse wave velocity (PWV) and ankle/brachial index, heart and renal target organ damage (TOD). The haemodynamic parameters were central (CAIx) and peripheral (PAIx) augmentation indices. RESULTS: In year 4, participants with type 2 diabetes had increased IMT thickness. These patients had more plaques and an IMT>0.90 mm. In participants with MetS, we only found an increase in the number of plaques. We found no changes in PWV, CAIx and PAIx. The patients with diabetes had a greater frequency of vascular TOD. There were no differences neither in renal nor cardiac percentage of TOD in the patients with MetS or diabetes mellitus type 2. CONCLUSIONS: This prospective study showed that the evolution of vascular TOD is different in participants with type 2 diabetes compared with those with MetS. While IMT and PWV increased in type 2 diabetes, these were not modified in MetS. The renal and cardiac TOD evolution, as well as the PAIx and CAIx, did not change in either group. TRIAL REGISTRATION NUMBER: NCT01065155; Results.
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Gómez‐Marcos et al. (2016) conducted a cohort in Increased insulin resistance (type 2 diabetes or metabolic syndrome) (n=112). Type 2 diabetes mellitus vs. Metabolic syndrome without type 2 diabetes was evaluated on Annual change in average carotid intima-media thickness (IMT, mm/year) over 4 years (p=0.011). Type 2 diabetes increased average carotid IMT by 0.010 mm/year vs 0.001 mm/year in metabolic syndrome (p=0.011) and PWV by 0.162 vs -0.182 m/s/year (p=0.002) over 4 years.
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