Metabolic syndrome in type 1 diabetes: Association with diabetic nephropathy and glycemic control (the FinnDiane study)

Lena M. Thorn, Carol Forsblom, Johan Fagerudd, Merlin C. Thomas, Kim Pettersson-Fernholm, Markku Saraheimo, Johan Wadén, Mats Rönnback, Milla Rosengärd-Bärlund, Clas Göran Af Björkesten, Marja Riitta Taskinen, Per Henrik Groop

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Abstract

OBJECTIVE - The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control. RESEARCH DESIGN AND METHODS - In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5%), intermediate (7.5-9.0%), or poor (>9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula. RESULTS - The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89-4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance. CONCLUSIONS - The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.

Original languageEnglish
Pages (from-to)2019-2024
Number of pages6
JournalDiabetes Care
Volume28
Issue number8
DOIs
Publication statusPublished - 1 Aug 2005
Externally publishedYes

Cite this

Thorn, Lena M. ; Forsblom, Carol ; Fagerudd, Johan ; Thomas, Merlin C. ; Pettersson-Fernholm, Kim ; Saraheimo, Markku ; Wadén, Johan ; Rönnback, Mats ; Rosengärd-Bärlund, Milla ; Björkesten, Clas Göran Af ; Taskinen, Marja Riitta ; Groop, Per Henrik. / Metabolic syndrome in type 1 diabetes : Association with diabetic nephropathy and glycemic control (the FinnDiane study). In: Diabetes Care. 2005 ; Vol. 28, No. 8. pp. 2019-2024.
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title = "Metabolic syndrome in type 1 diabetes: Association with diabetic nephropathy and glycemic control (the FinnDiane study)",
abstract = "OBJECTIVE - The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control. RESEARCH DESIGN AND METHODS - In all, 2,415 type 1 diabetic patients (51{\%} men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5{\%}), intermediate (7.5-9.0{\%}), or poor (>9.0{\%}). Creatinine clearance was estimated with the Cockcroft-Gault formula. RESULTS - The overall prevalence of metabolic syndrome was 38{\%} in men and 40{\%} in women. The prevalence was 28{\%} in those with normal AER, 44{\%} in microalbuminuric patients, 62{\%} in macroalbuminuric patients, and 68{\%} in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95{\%} CI 2.89-4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31{\%} in patients with good glycemic control, 36{\%} in patients with intermediate glycemic control, and 51{\%} in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance. CONCLUSIONS - The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.",
author = "Thorn, {Lena M.} and Carol Forsblom and Johan Fagerudd and Thomas, {Merlin C.} and Kim Pettersson-Fernholm and Markku Saraheimo and Johan Wad{\'e}n and Mats R{\"o}nnback and Milla Roseng{\"a}rd-B{\"a}rlund and Bj{\"o}rkesten, {Clas G{\"o}ran Af} and Taskinen, {Marja Riitta} and Groop, {Per Henrik}",
year = "2005",
month = "8",
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doi = "10.2337/diacare.28.8.2019",
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Thorn, LM, Forsblom, C, Fagerudd, J, Thomas, MC, Pettersson-Fernholm, K, Saraheimo, M, Wadén, J, Rönnback, M, Rosengärd-Bärlund, M, Björkesten, CGA, Taskinen, MR & Groop, PH 2005, 'Metabolic syndrome in type 1 diabetes: Association with diabetic nephropathy and glycemic control (the FinnDiane study)', Diabetes Care, vol. 28, no. 8, pp. 2019-2024. https://doi.org/10.2337/diacare.28.8.2019

Metabolic syndrome in type 1 diabetes : Association with diabetic nephropathy and glycemic control (the FinnDiane study). / Thorn, Lena M.; Forsblom, Carol; Fagerudd, Johan; Thomas, Merlin C.; Pettersson-Fernholm, Kim; Saraheimo, Markku; Wadén, Johan; Rönnback, Mats; Rosengärd-Bärlund, Milla; Björkesten, Clas Göran Af; Taskinen, Marja Riitta; Groop, Per Henrik.

In: Diabetes Care, Vol. 28, No. 8, 01.08.2005, p. 2019-2024.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Metabolic syndrome in type 1 diabetes

T2 - Association with diabetic nephropathy and glycemic control (the FinnDiane study)

AU - Thorn, Lena M.

AU - Forsblom, Carol

AU - Fagerudd, Johan

AU - Thomas, Merlin C.

AU - Pettersson-Fernholm, Kim

AU - Saraheimo, Markku

AU - Wadén, Johan

AU - Rönnback, Mats

AU - Rosengärd-Bärlund, Milla

AU - Björkesten, Clas Göran Af

AU - Taskinen, Marja Riitta

AU - Groop, Per Henrik

PY - 2005/8/1

Y1 - 2005/8/1

N2 - OBJECTIVE - The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control. RESEARCH DESIGN AND METHODS - In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5%), intermediate (7.5-9.0%), or poor (>9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula. RESULTS - The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89-4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance. CONCLUSIONS - The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.

AB - OBJECTIVE - The aim of this study was to estimate the prevalence of the metabolic syndrome in Finnish type 1 diabetic patients and to assess whether it is associated with diabetic nephropathy or poor glycemic control. RESEARCH DESIGN AND METHODS - In all, 2,415 type 1 diabetic patients (51% men, mean age 37 years, duration of diabetes 22 years) participating in the nationwide, multicenter Finnish Diabetic Nephropathy (FinnDiane) study were included. Metabolic syndrome was defined according to the National Cholesterol Education Program diagnostic criteria. Patients were classified as having normal albumin excretion rate (AER) (n = 1,261), microalbuminuria (n = 326), macroalbuminuria (n = 383), or end-stage renal disease (ESRD) (n = 164). Glycemic control was classified as good (HbA1c <7.5%), intermediate (7.5-9.0%), or poor (>9.0%). Creatinine clearance was estimated with the Cockcroft-Gault formula. RESULTS - The overall prevalence of metabolic syndrome was 38% in men and 40% in women. The prevalence was 28% in those with normal AER, 44% in microalbuminuric patients, 62% in macroalbuminuric patients, and 68% in patients with ESRD (P < 0.001). Patients with metabolic syndrome had a 3.75-fold odds ratio for diabetic nephropathy (95% CI 2.89-4.85), and all of the separate components of the syndrome were independently associated with diabetic nephropathy. The prevalence of metabolic syndrome was 31% in patients with good glycemic control, 36% in patients with intermediate glycemic control, and 51% in patients with poor glycemic control (P < 0.001). Similarly, metabolic syndrome increased with worsening creatinine clearance. CONCLUSIONS - The metabolic syndrome is a frequent finding in type 1 diabetes and increases with advanced diabetic nephropathy and worse glycemic control.

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U2 - 10.2337/diacare.28.8.2019

DO - 10.2337/diacare.28.8.2019

M3 - Article

C2 - 16043748

AN - SCOPUS:23044481147

VL - 28

SP - 2019

EP - 2024

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 8

ER -