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Background: There is a common pathophysiological basis rooted in insulin resistance for both Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS). Their coexistence significantly amplifies cardiovascular morbidity and mortality. Objective: To evaluate the prevalence of metabolic syndrome (MetS) among patients with Type 2 Diabetes mellitus (T2DM) aged ≥ 30 years and assess the clinical and biochemical correlations between diabetes parameters and components of metabolic syndrome. Methods: A cross-sectional study was conducted over one year in fifty admitted patients aged ≥ 30 years with established T2DM in the Department of General Medicine at Shri Guru Ram Rai Institute of Medical and Health Sciences, Shri Mahant Indiresh Hospital, Dehradun, Uttarakhand, India. Metabolic syndrome was diagnosed using NCEP ATP III criteria. Anthropometric, clinical, and biochemical variables were recorded and analyzed using appropriate statistical tests. Results: Among 50 admitted participants (mean age 53.6 ± 9.1 years), 28 patients (56%) fulfilled criteria for metabolic syndrome. Most prevalent components were Central obesity (72%), hypertension (68%), and low HDL cholesterol (60%). Mean BMI was significantly higher in the metabolic syndrome group (30.4 ±2.6 kg/m²) compared to non-metabolic syndrome group (27.9 ± 2.3 kg/m2; p<0.001). In MetS patients, mean HbA1c levels were also higher (8.6 ± 1.1%) in comparison to non-MetS (7.8 ±0.9%; p=0.02). There were significant positive correlations between waist circumference and triglyceride levels (r=0.48, p=0.003). Conclusion: It was observed that more than half of Type 2 DM patients over 30 years demonstrated metabolic syndrome. Major dominant contributors were central obesity and hypertension. Routine MetS screening should be integrated into diabetes management to reduce cardiovascular risk burden.
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia due to insulin resistance and relative insulin deficiency. It constitutes a major public health challenge globally and in India. Metabolic syndrome (MetS) is a constellation of interrelated risk factors – central obesity, dyslipidemia, hypertension, and hyperglycemia- that substantially increase cardiovascular risk1.
There is pathophysiological overlap between T2DM and MetS which lies primarily in insulin resistance, chronic inflammation, adipokine imbalance, and endothelial dysfunction2. Patients having both conditions demonstrate significantly higher risk of coronary artery disease, stroke, nephropathy, and overall mortality 3.
There was particularly high predisposition to central obesity and dyslipidemia at lower BMI thresholds in Indian populations, making evaluation of MetS among diabetics clinically imperative4.
This cross-sectional study was conducted to determine:
Study Design: Cross-sectional hospital-based study.
Study Setting: Department of General Medicine, Shri Guru Ram Rai Institute of Medical and Health Sciences, Shri Mahant Indiresh Hospital, Dehradun, Uttarakhand, India.
Duration: One year.
Sample Size: 50 admitted patients meeting inclusion criteria.
Inclusion Criteria:
Exclusion Criteria:
Data collection:
The following variables were recorded:
Definition of Metabolic Syndrome:
MetS diagnosed using NCEP ATP III criteria (presence of ≥3):
Statistical Analysis:
Demographic Profile
|
Parameter |
Overall (n=50) |
|
Mean age |
53.6 ± 9.1 years |
|
Male |
28 (56%) |
|
Female |
22 (44%) |
|
Mean BMI |
29.3 ± 3.2 kg/m2 |
|
Mean Waist Circumference |
95.4 ± 9.6 cm |
Prevalence of Metabolic Syndrome:
Distribution of MetS Components:
|
Component |
Frequency (%) |
|
Central obesity |
72% |
|
Hypertension |
68% |
|
Low HDL |
60% |
|
High Triglycerides |
46% |
|
Elevated Fasting Glucose |
100% |
Comparison Between MetS and Non-MetS Groups:
|
Parameters |
MetS |
Non-MetS (n=22) |
p-value |
|
BMI (kg/m2) |
30.4 ± 2.6 |
27.9 ± 2.3 |
<0.001 |
|
Waist Circumference (cm) |
101.2 ± 6.8 |
88.3 ± 5.9 |
<0.001 |
|
HbA1c (%) |
8.6 ± 1.1 |
7.8 ± 0.9 |
0.02 |
|
Triglycerides (mg/dl) |
178 ± 42 |
132 ± 30 |
0.01 |
|
HDL (mg/dl) |
37.5 ± 5.2 |
44.3 ± 6.1 |
0.004 |
Correlation Analysis:
The present cross-sectional study demonstrates a 56% prevalence of metabolic syndrome among type 2 diabetes mellitus patients above 30 years of age.
Key observations:
The clustering of dyslipidemia with central adiposity reflects underlying insulin resistance and hepatic overproduction of VLDL particles5.
Clinical Implications:
Strengths:
Limitations:
In our study at this tertiary care hospital setting, metabolic syndrome affects more than half of T2DM patients above 30 years of age. Predominant contributors are central obesity and hypertension. Early identification and targeted management are essential to prevent cardiovascular complications.
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