METABOLIC SYNDROME, INCIDENCE OF DIABETES AND MORTALITY AMONG ELDERLY: THE ITALIAN LONGITUDINAL STUDY ON AGING M Noale, S Maggi, F Limongi, P Siviero, G Romanato, G Crepaldi CNR, Institute of Neuroscience, Padova (Italy) MGSD 2011 Casablanca, Morocco The Metabolic Syndrome (MetS) is a clustering of metabolic and physiologic disorders, affecting an important part of the Italian elderly population: results from the ILSA study show that it is present in 31.5% of older men and 59.8% of older women. Because of its association with insulin resistance, subjects with MetS are more likely to have type 2 diabetes (T2D). The aim of the present work is to investigate if MetS can predict incidence of T2D and if it exists a synergic association MetS-T2D and all-cause mortality among elderly subjects.

MATERIAL AND METHODS The analyses are based on data collected by the Italian Longitudinal Study on Aging (ILSA): Logistic regression models were defined to study the influence of MetS on incidence of T2D, adjusting for age, sex, individual Mets components. Data on mortality collected between baseline and 1996 follow-up were considered, and Cox Ph Models defined to determine the death risk attributation to the synergic association of MetS and T2D. Sample (Maggi et al, 1994) :  5,632 free-dwelling and institutionalised individuals  aged  resident in 8 centers  randomly selected from the local anagraphic lists, equal allocation by sex and 5-year-age groups  with two phases  Screening phase, with personal interview, laboratory test, and diagnostic tests (MMSE, neurological tests, GDS, ADL, IADL, spirometry, retinography, electrocardiography)  Clinical confirmation by geriatrician or neurologist for those subjects screened positive for heart failure, angina, arrhythmia, hypertension, myocardial infarction, diabetes, stroke, parkinsonism, distal symmetric neuropathy of lower limbs, dementia MILANO GENOVA FIRENZE PADOVA FERMO NAPOLI CATANIA BARI

RESULTS INCIDENCE OF DIABETES INCIDENT CASES OF DIABETES (n=68) OR95% CIp-value Metabolic syndrome Abdominal obesity Triglycerides HDL cholesterol Fasting Glucose < Blood pressure (model adjusted for age, sex, individual MetS criteria)

RESULTS ALL CAUSE MORTALITY Subjects with or without diabetes at baseline (n=3,081) Subjects without diabetes and MetS (T2D- MetS-, n=1,529) Subjects with diabetes but without MetS (T2D+ MetS- n=92) Subjects without diabetes but with MetS (T2D- MetS+ n=1,132) Subjects with diabetes and MetS (T2D+ MetS+, n=328) ALL CAUSE MORTALITY (n=297 death) HR95% CIp-value T2D – MetS T2D + MetS T2D – MetS T2D + MetS ( model adjusted for age, sex, individual MetS criteria, education, smoking status, marital status, hypertension, myocardial infarction, heart failure, angina, ictus, distal symmetric neuropathy, arrhythmia, disability in ADL, disability in IADL) CONCLUSION MetS is associated with incidence of T2D, and the synergic association MetS-T2D is an important risk factor for all-cause mortality among elderly subjects.