(05-12-05) Metabolic syndrome and insulin resistance both predict cardiovascular risk

NEW YORK (Reuters Health) - Both the metabolic syndrome and insulin resistance "are strong and mutually independent predictors" of vascular risk in patients undergoing coronary angiography, according to a report in the October issue of The Journal of Clinical Endocrinology & Metabolism.

Insulin resistance is an established predictor of cardiovascular disease, the authors note, but few studies have examined the predictive power of the metabolic syndrome in patients already affected by cardiovascular disease.
Dr. Heinz Drexel from Voralberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria and colleagues evaluated the impact of insulin resistance and the metabolic syndrome on future vascular events among 750 patients who underwent coronary angiography for the evaluation of coronary artery disease.
During a mean follow-up of 2.3 years, new vascular events were more common in men than in women, in diabetics than in nondiabetics, and in patients with significant coronary artery stenoses than in patients without such lesions, the authors report.
Metabolic syndrome independently predicted the incidence of vascular events, the results indicate, and event-free survival was significantly lower in patients with rather than without metabolic syndrome.
Metabolic syndrome remained significantly predictive of vascular events after adjustment for insulin resistance, the researchers note, and insulin resistance added to the prognostic value of metabolic syndrome.
Metabolic syndrome and insulin resistance independently predicted vascular events after adjusting for the presence of type 2 diabetes, the report indicates.
"We conclude that both the clinical diagnosis of the metabolic syndrome and biomarkers of insulin resistance should be considered in cardiovascular risk estimation," the investigators write. "Whether pharmacological improvement of the metabolic syndrome and insulin sensitivity, as with thiazolidinedione treatment, translates into improved cardiovascular outcome is a question of major clinical importance."

Source : J Clin Endocrinol Metab 2005;90:5698-5703.

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