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Metabolic Syndrome and Cardiovascular Mortality in Older Type 2 Diabetic Patients: A Longitudinal Study

¹ Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatrics, University of Florence, Italy.
² Epidemiology Unit, Local Health Unit 10, Florence, Italy.

Address correspondence to Edoardo Mannucci, MD, Department of Critical Care Medicine and Surgery, Unit of Gerontology and Geriatrics, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Via delle Oblate 4, 50134 Florence, Italy. E-mail: edoardo.mannucci{at}fastwebnet.it and mmonami{at}libero.it

Abstract

Background. Although age does not seem to modify the association of the metabolic syndrome (MS) with cardiovascular risk in middle-aged individuals, no comparison of risks associated with MS between old and middle-aged persons has been reported so far.

Methods. An observational study was performed on a consecutive series of 1716 type 2 diabetic outpatients (age range: 28–96 years). The diagnosis of MS was made following either the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATPIII) or the International Diabetes Federation (IDF) criteria.

Results. The difference in cardiovascular mortality between patients with and without MS was significant up to the age of 70 years. After adjusting for age and sex, hazard ratios of MS for cardiovascular mortality were 3.03 (95% confidence interval, 1.45–6.29), 1.56 (0.91–2.68), and 1.17 (0.42–3.22) in patients 70, 71–80, and >80 years old, respectively.

Conclusions. MS is associated with increased cardiovascular risk in middle-aged type 2 diabetic patients, and the clinical utility of this category in older diabetic individuals is questionable.

Key Words: Diabetes mellitus • Advanced age • Cardiovascular mortality • Metabolic syndrome