By Martha Kerr NEW YORK (Reuters Health) Dec 27 - The metabolic syndrome is an independent clinical indicator of micro- or macrovascular complications in diabetes, according to a report in the December issue of Diabetes Care. The syndrome may even be involved in the pathogenesis of vascular complications. The Metascreen Writing Committee, headed by Dr. Bonnadonna Riccardo of Ospedale Civile Maggiore in Verona, Italy, analyzed the effect of the metabolic syndrome on vascular complications in 8,497 patients. Of these, 7,859 had type 2 diabetes and 638 had type 1 diabetes. The Committee analyzed the link according to two different definitions: that of the National Heart, Lung, and Blood Institute/American Heart Association (NHLBI/AHA) and definition accepted by the International Diabetes Federation (IDF). The diagnostic criteria for the NHLBI/AHA definition are abdominal obesity, atherogenic dyslipidemia, elevated blood pressure and elevated blood glucose. The IDF definition consists of abdominal obesity, using a lower diagnostic threshold, and somewhat more ambiguous indicators of cardiovascular risk. "Either definition of the metabolic syndrome was an independent statistical indicator" of nephropathy and neuropathy in type 1 diabetes and of all types of cardiovascular complications, including retinopathy, in type 2 diabetes, the investigators report. "This study is cross-sectional; hence, it provides evidence that the metabolic syndrome is only a risk indicator of concomitant specific and non-specific complications in both types of diabetes," Dr. Riccardo told Reuters Health. "However, from all we know, the presence of the entity we call today 'metabolic syndrome' in a patient with diabetes conveys a higher risk of developing diabetic complications over time." The various definitions of metabolic syndrome cause confusion and "are somewhat wanting," Dr. Riccardo said. "Further studies will be needed to refine them and to give stronger and wider support to their clinical applicability and use." "The findings of the present study are actually in favor of the clinical usefulness of the 'metabolic syndrome' as currently defined. Indeed, in this study the dichotomous categorization metabolic syndrome yes/no is as effective as the component parts of the syndrome in marking the presence of diabetic complications," the Italian investigator said. Diabetes Care 2006;29:2701-2707.