• Muhammad Abdul-Ghani, Gamal Nawaf, Fawaz Nawaf, Baruch Itzhak, Oscar Minuchin, and Pnina Vardi.
• Department of Diabetes, Lin Medical Center, Clalit Health Services, Haifa, Israel. abdulghani@uthscsa.edu
• Isr Med Assoc J. 2006 Jun 1; 8 (6): 378-82.

BackgroundMicrovascular complications of diabetes contribute significantly to the disease morbidity. The metabolic syndrome is common among subjects with diabetes and is a very important risk factor for macrovascular complications. However, its contribution to the microvascular complication has not been assessed.ObjectivesTo assess the risk of microvascular complications associated with the metabolic syndrome in diabetes subjects.MethodsThe study group comprised 415 diabetic subjects attending a primary care clinic. The prevalence of microvascular complications was compared between 270 diabetic subjects with metabolic syndrome (NCEP-III criteria) and 145 diabetic patients without.ResultsWe found that as a group, diabetic subjects with metabolic syndrome had a significantly higher frequency of microvascular-related complications than diabetic subjects without the syndrome (46.6% and 26.8% respectively, P= 0.0005). These include microalbuminuria (41.5% vs. 23.9%, P= 0.013), neuropathy (10.4% vs. 7.5%, P = 0.38), retinopathy (9.6% vs. 4.1%, P = 0.046) and leg ulcers (7.9% vs. 2.8%, P = 0.044). After adjustment for age, gender, glycemic control, disease duration, lipid profile and blood pressure, metabolic syndrome was associated with a significantly higher risk of microvascular complications: odds ratio (95% confidence interval) for nephropathy 2.27 (1.53-3.34), neuropathy 1.77 (0.79-4.0), retinopathy 3.42 (1.2-9.87), and leg ulcers 3.57 (1.08-11.95).ConclusionsIn addition to hyperglycemia and disease duration, the metabolic syndrome is a significant risk factor for the development of microvascular complications in diabetic subjects.

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