The Burden of Multiple Metabolic Diseases and Their Impact on Cardiovascular and Kidney Complications in Type 2 Diabetes: A 10-Year Real-World Study

Man-Rong Xu,1 Meng-Han Li,1 Ya-Wen Zhang,1 Jun-Xi Lu,1 Lian-Xi Li,1 Yu-Ren Zhang2 1Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, 200233, People’s Republic of China; 2Department of Endocrinology and Metabolism, Jinjiang Municipal Hospital, Shanghai Sixth People’s Hospital Fujian, Quanzhou, Fujian, 362200, People’s Republic of ChinaCorrespondence: Lian-Xi Li, Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, People’s Republic of China, Tel +8602124058337, Fax +86021-64519943, Email [email protected] Yu-Ren Zhang, Department of Endocrinology and Metabolism, Jinjiang Municipal Hospital, Shanghai Sixth People’s Hospital Fujian, 16 Jinguang Road, Jinjiang City, Quanzhou, Fujian, 362200, People’s Republic of China, Tel +8615060969798, Fax +860595-85673434, Email [email protected]: Although metabolic diseases (MDs) in type 2 diabetes mellitus (T2DM) have been discussed, few studies have comprehensively investigated the prevalence, clinical features, and impact of multiple MDs in T2DM. We aimed to analyze the prevalence and clinical characteristics of multiple MDs including hypertension (HTN), obesity (OB), hyperlipidaemia (HLP), hyperuricaemia (HUA), atherosclerosis (AS), and metabolic dysfunction-associated fatty liver disease (MAFLD) in T2DM patients, and to evaluate the impact of multiple MDs on cardiovascular and kidney complications.Patients and Methods: This large real-world study involving 9453 T2DM patients was conducted from 2003 to 2012. The clinical features were compared between those with and without MDs. The impact of MDs on cardio-cerebrovascular events (CCBVEs) and chronic kidney disease (CKD) was investigated.Results: The overall prevalence of MDs was 92.6% in T2DM patients, which remained consistently high from 2003 to 2012 and increased with age and diabetes duration (DD) except for MAFLD. HLP had the highest prevalence in both males and females, while HUA had the lowest. Among T2DM patients, the prevalences of CCBVEs and CKD were significantly higher in those with MDs than in those without (all P< 0.001), and increased progressively with the number of MDs (all P< 0.001).Conclusion: The prevalence of comorbid MDs in T2DM patients was consistently high from 2003 to 2012. The presence of MDs in T2DM patients significantly increased the risk and severity of cardiovascular and kidney complications. Therefore, early screening and intervention for MDs may help to reduce the risk of macrovascular and microvascular complications in T2DM.Keywords: type 2 diabetes, metabolic diseases, cardiovascular complications, chronic kidney disease