As compared with patients with no METS and no type 2 diabetes mellitus ( DM ) , the risk of all-cause and HF death was significantly lower in patients with METS and no DM ( HR : 0.76 , 95 % CI : 0.62 to 0.95 , p = 0.015 ; HR : 0.65 , 95 % CI : 0.42 to 0.99 , p = 0.046 ; respectively ) , whereas it was significantly increased in patients with DM and no METS ( HR : 1.34 , 95 % CI : 1.21 to 1.48 , p < 0.001 ; HR : 1.44 , 95 % CI : 1.21 to 1.72 , p < 0.001 ; respectively ) .