Diabetes, Heart Disease Risks Can't Be Grouped, Researchers Say
By Chantal Britt
May 22 (Bloomberg) -- Doctors should look at risks for diabetes and heart disease individually instead of trying to find criteria that predict a patient's potential for developing both, raising questions about the treatment of 50 million Americans.
Since the 1970s, physicians have used so-called metabolic syndrome to assess the risk of patients with decreased levels of good cholesterol, fatter waists, and high blood pressure as well as raised blood sugar and fat levels of developing diabetes and heart disease.
Although metabolic syndrome and its components are associated with type 2 diabetes, they have weak or no association with vascular dangers in the elderly, Scottish researchers writing today in the Lancet medical journal said. Physicians developed the criteria to better understand the links between the pre-diabetes state and heart disease. It requires individuals to have three of five medical disorders that were thought to identify individuals at risk of either condition.
``Attempts to define criteria that simultaneously predict risk for both cardiovascular disease and diabetes are unhelpful,'' said Naveed Sattar from the University of Glasgow.
The metabolic syndrome combines health issues such as raised blood sugar levels, decreased levels of good HDL cholesterol, and elevated levels of triglycerides in the blood to predict risk for heart disease and diabetes. It doesn't include known factors such as age, cholesterol and smoking.
50 Million Americans
The term metabolic syndrome has been commonly used since the late 1970s. It affects about 50 million Americans, according to the American Heart Association. Sattar's study was funded by Diabetes UK and the British Heart Foundation.
Sattar analyzed data from two studies with more than 7,500 non-diabetic people between 60 and 82 years old to investigate to what extent metabolic syndrome and its individual components were related to the risks of these two diseases in elderly populations.
In people without heart disease, metabolic syndrome wasn't linked to an increased risk of cardiovascular disorders, but to a more-than-four-fold risk of diabetes, Sattar found.
In patients with cardiovascular problems, it was associated with a 27 percent increased risk of heart disease and a more than seven-fold risk of diabetes. Body mass index or waist circumference, blood fat triglyceride levels, and blood sugar cutoff points didn't predict a higher risk for heart disease, but were associated with risk of new-onset diabetes.
``Both actions would better serve the health of those at risk of diabetes and cardiovascular disease than seeking a diagnosis of the metabolic syndrome,'' Richard Khan from the American Diabetes Association said in a comment. ``Diagnosis of the metabolic syndrome has no apparent clinical value. Naveed Sattar and co-workers put yet another nail in the coffin of the metabolic syndrome.''
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