1791-LB: Metabolic Syndrome (MS) as a Risk Factor for Myocardial Infarction (MI), Coronary Heart Disease (CHD), Stroke, and Peripheral Artery Disease (PAD) in 41,215 People with Type 1 Diabetes (PwT1D)
Authors: SEUFERT JOCHEN , LAUBNER KATHARINA , MERGER SIGRUN R. , MADER JULIA K. , HUMMEL MICHAEL , PAVEL MARIANNE , HESS GREGOR , ZIMNY STEFAN , HOLL REINHARD W. , PRINZ NICOLE , THE DPV INITIATIVE FOR 
Published: June 2024

Objective: To address the association between components of the MS and the occurrence of CV end-points in PwT1D.
Methods: 14,328 PwT1D with MS (≥2 of 4 criteria: BMI&gt;30kg/m2, RR≥140/90mmHg, microalbuminuria, Trig≥150mg/dl or HDL&lt;35mg/dl were compared to 26.887 PwT1D without MS for CV risk factors (Median [Q1;Q2]) and the occurrence of MI, CHD, stroke and PAD (OR; 95%CI).
Results: PwT1D and MS (57.6% m) vs without MS (52.6%) were older (53.1 years [37.4;65.5] vs 27.8 [19.5;46.4]), had longer diabetes duration (18.4 years [8.4;31.4] vs 10.3 [4.9;17.6]), higher BMI (27.9kg/m2 [24.0; 32.1] vs 23.8 [21.7;26.2]), RRsys (135mmHg [125; 145] vs 124 [118;131]), and triglycerides (144mg/dl [94; 203] vs 92 [67;128]) (p all&lt;0,001), no differences in HbA1c (7.8% [6.9;9.0] vs 7.7% [6.9;8.9]) and total daily insulin dose (50.0IU [34.5;70.0] vs 49.3IU [35.0;65.2]). MS in PwT1D significantly increased the risk for the CV outcomes MI, CHD, stroke and PAD (Fig.). Dyslipidemia and hypertension provided highest risk for all CV outcomes, albuminuria contributed to the PAD risk, while HbA1c and obesity showed lower odds.
Conclusions: Components of the MS account for a substantially increased risk for CV outcomes in PwT1D. Targeted CV risk factor management in addition to glucose control is essential to prevent CV endpoints in PwT1D.

Disclosure
J. Seufert: Consultant; Sanofi. Advisory Panel; Boehringer-Ingelheim. Research Support; Boehringer-Ingelheim. Speaker's Bureau; Boehringer-Ingelheim, Sanofi, Lilly Diabetes. Advisory Panel; Abbott. Speaker's Bureau; Abbott, Novo Nordisk. Advisory Panel; Novo Nordisk. K. Laubner: Speaker's Bureau; Novo Nordisk, AstraZeneca, Sanofi, MedUpdate GmbH, Germany, Davos Destinations-Organisation, Suisse, Vincentius-Diakonissen-Kliniken gAG, Germany. Other Relationship; Thime Verlag, Germany. Speaker's Bureau; Boehringer-Ingelheim, Lipidliga. S.R. Merger: Other Relationship; Eli Lilly and Company, Novo Nordisk, AstraZeneca. J.K. Mader: Advisory Panel; Becton, Dickinson and Company. Speaker's Bureau; Becton, Dickinson and Company, A. Menarini Diagnostics, Boehringer-Ingelheim, diaTribe. Other Relationship; Diabetes UK. Stock/Shareholder; decide Clinical Software GmbH. Advisory Panel; embecta. Speaker's Bureau; embecta, Viatris Inc., Eli Lilly and Company. Advisory Panel; Eli Lilly and Company, Medtronic. Speaker's Bureau; Medtrust. Advisory Panel; Novo Nordisk A/S. Speaker's Bureau; Novo Nordisk A/S. Advisory Panel; PharmaSens, Roche Diabetes Care. Speaker's Bureau; Roche Diabetes Care. Board Member; Sanofi-Aventis Deutschland GmbH. Speaker's Bureau; Sanofi-Aventis Deutschland GmbH, Sanofi, Dexcom, Inc., Viatris Inc. Advisory Panel; Viatris Inc. Speaker's Bureau; Ypsomed AG. Research Support; European Union. Stock/Shareholder; elyte Diagnostics GmbH. Other Relationship; elyte Diagnostics GmbH. Board Member; European Association for the Study of Diabetes. Research Support; European Union Aviation Safety Agency. M. Hummel: None. M. Pavel: Other Relationship; Boehringer-Ingelheim. Advisory Panel; Crinetics Pharmaceuticals, Inc. Consultant; Novartis Pharmaceuticals Corporation. Other Relationship; Novartis Pharmaceuticals Corporation, Sanofi-Aventis Deutschland GmbH. Consultant; IPSEN. Other Relationship; Lilly GmbH. Consultant; ITM. G. Hess: None. S. Zimny: None. R.W. Holl: None. N. Prinz: None.

Funding
German Federal Ministry for Education and Research within the German Centre for Diabetes Research (Grant Number: 82DZD14E03)