EVALUATION OF RISK MARKERS OF CVD IN METABOLIC SYNDROME
Metabolic syndrome (MetS) is a pathological condition varying according to the guidelines used, leading to ongoing debate on whether all these forms of defining MetS offer the same level of risk for developing cardiovascular diseases (CVDs). The aim of the study was: 1) to determine the prevalence of each type of MetS; 2) to assess the association of each type with CVDs over a 5-year follow-up period; and 3) to analyze whether each possible combination of MetS carries the same level of risk for developing CVD in the time above frame. Metabolic syndrome is one of the major public health issues with 30–40% probability of developing type 2 Diabetes Mellitusand/or cardiovascular disease.On extensive search of literature we could hardly find any study which could and a strong correlation between basal C-peptide and insulin levels as a risk marker for CVD and whatever was available the workers have tried to establish that high C-peptide levels coexists with hyperinsulinemia in metabolic syndrome.So we tried to explore the levels of C-peptide and insulin as a risk marker of CVD in the patients of metabolic syndrome.After obtaining ethical clearance, a total of 267 patients of metabolic syndrome were selected and enrolled for the present study. All the patients were subjected to complete general and systemic examination and findings noted. Waist circumference was also recorded in all of them.The special investigations like lipid profile, LFT, KFT, fasting blood glucose, C-peptide and Insulin levels were estimated in all the cases and findings recorded and statistically analysed. Out of the total of 267 subjects,15 (5.6%), 12 (4.5%) and 240 (89.8%) had C- peptide level <0.78 (mean± SD 0.49 ±0.24), 0.78-1.89 (mean± SD 1.35 ±0.45) and >1.89(mean± SD 6.14±3.47) respectively while in 3 (1.1%), 198 (74.1%) and 66 (24.7%) subjects, the insulin levels were found to be in <2 (mean± SD 1.8±0.0), 2-25 (mean± SD 13.05±26.58) and >25 (mean± SD 43.1±16.85) respectively. In our study 240 (89.8 %) subjects were having elevated C-peptide which is statistically significant (p<0.001), whereas only 66 (24.75) subjects had evaluated insulin level with no statistical significance. Therefore we came to a conclusion that fasting serum C-peptide levels is a better risk marker of CVD rather than fasting insulin levels in patients with Metabolic Syndrome. Significant variations in the prevalence of MetS according to the definition used were revealed, as well as significant differences in the risk of CVD associated with different types of MetS.