Metabolic syndrome showed significant relationship with carotid atherosclerosis

Abstract Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease. We assessed the associations between MetS and the indicators of carotid atherosclerosis as assessed by ultrasonography taking into consideration of confounders in the general population. A total of 1281 subjects (856 males, 425 females) were included in the present study. The total plaque score and maximum intima-media thickness (IMT) of the carotid arteries were measured as indicators of atherosclerosis. Cardiovascular risk factors were several metabolic components, serum uric acid, serum C-reactive protein (CRP), and lifestyle factors. MetS was defined according to the criteria of the National Cholesterol Education Program. The prevalences of an elevated total plaque score (≥5) and elevated IMT (>1 mm) of the carotid arteries were significantly higher in subjects with MetS as compared to subjects without MetS. Furthermore, a trend was observed towards higher prevalences of these indicators of atherosclerosis as the number of components of MetS increased. Logistic regression analysis revealed a significant association between elevated plaque score and MetS even after adjustments for age, serum uric acid, serum CRP and lifestyle factors in the males. Among the indicators of atherosclerosis assessed by carotid ultrasonography, a significant independent association was observed between the total plaque score and MetS in males in the general population.

[1]  Gilles Chironi,et al.  The value of carotid intima-media thickness for predicting cardiovascular risk. , 2010, Arteriosclerosis, thrombosis, and vascular biology.

[2]  Michael J Blaha,et al.  High-sensitivity C-reactive protein and cardiovascular disease: a resolute belief or an elusive link? , 2013, Journal of the American College of Cardiology.

[3]  R. Kronmal,et al.  Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. , 1999, The New England journal of medicine.

[4]  Stein Harald Johnsen,et al.  Carotid plaque compared with intima-media thickness as a predictor of coronary and cerebrovascular disease , 2009, Current cardiology reports.

[5]  J. Willerson,et al.  Inflammatory markers in coronary heart disease. , 2011, British medical bulletin.

[6]  Arno W. Hoes,et al.  Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. , 1997, Circulation.

[7]  A. Kamitani,et al.  Metabolic syndrome, diabetes and subclinical atherosclerosis as assessed by carotid intima-media thickness. , 2007, Journal of atherosclerosis and thrombosis.

[8]  Pierre Amarenco,et al.  High-density lipoprotein-cholesterol and risk of stroke and carotid atherosclerosis: a systematic review. , 2008, Atherosclerosis.

[9]  W. Koenig.  Predicting risk and treatment benefit in atherosclerosis: the role of C-reactive protein. , 2005, International journal of cardiology.

[10]  E. Ford.  Risks for all-cause mortality, cardiovascular disease, and diabetes associated with the metabolic syndrome: a summary of the evidence. , 2005, Diabetes care.

[11]  J David Spence,et al.  Measurement of Intima-Media Thickness vs. Carotid Plaque: Uses in Patient Care, Genetic Research and Evaluation of New Therapies , 2006, International journal of stroke : official journal of the International Stroke Society.

[12]  K. Okumura,et al.  High HDL cholesterol level after treatment with pitavastatin is an important factor for regression in carotid intima–media thickness , 2015, Heart and Vessels.

[13]  S. Kiechl,et al.  Carotid atherosclerosis and coronary heart disease in the metabolic syndrome: prospective data from the Bruneck study. , 2003, Diabetes care.

[14]  J. Pankow,et al.  Metabolic syndrome risk for cardiovascular disease and diabetes in the ARIC study , 2008, International Journal of Obesity.

[15]  Shankuan Zhu,et al.  Metabolic syndrome in the prevention of cardiovascular diseases and diabetes—still a matter of debate? , 2013, European Journal of Clinical Nutrition.

[16]  J. Kastelein,et al.  Controversies in cardiovascular medicine C-reactive protein is a mediator of cardiovascular disease , 2010 .

[17]  R. Bhopal,et al.  A comparison of the new international diabetes federation definition of metabolic syndrome to WHO and NCEP definitions in Chinese, European and South Asian origin adults. , 2007, Ethnicity & disease.

[18]  H. M. den Ruijter,et al.  Common Carotid Intima-Media Thickness Measurements in Cardiovascular Risk Prediction: A Meta-Analysis , 2012 .

[19]  S. Bergmann,et al.  Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis. , 2011, Atherosclerosis.

[20]  D. van Klaveren,et al.  Carotid intima-media thickness for cardiovascular risk assessment: systematic review and meta-analysis. , 2013, Atherosclerosis.

[21]  T. Tuomainen,et al.  Augmentation index and carotid intima–media thickness are differently related to age, C-reactive protein and oxidized low-density lipoprotein , 2007, Journal of hypertension.

[22]  A. Tosetto,et al.  Carotid Plaque Morphology Improves Stroke Risk Prediction: Usefulness of a New Ultrasonographic Score , 2011, Cerebrovascular Diseases.

[23]  T. Otsuka,et al.  Two‐hour post‐load plasma glucose levels are associated with carotid intima‐media thickness in subjects with normal glucose tolerance , 2014, Diabetic medicine : a journal of the British Diabetic Association.

[24]  R. Sacco,et al.  The metabolic syndrome and subclinical carotid atherosclerosis: the Northern Manhattan Study. , 2007, Journal of the cardiometabolic syndrome.

[25]  O H Førde,et al.  The Tromsø Study. Distribution and population determinants of gamma-glutamyltransferase. , 1990, American journal of epidemiology.

[26]  K. Chien,et al.  C-reactive protein and the metabolic syndrome correlate differently with carotid atherosclerosis between men and women in a Taiwanese community. , 2008, Metabolism: clinical and experimental.

[27]  R. Sacco,et al.  Carotid plaque, a subclinical precursor of vascular events , 2008, Neurology.

[28]  E. Mathiesen,et al.  The metabolic syndrome and progression of carotid atherosclerosis over 13 years. The Tromsø study , 2012, Cardiovascular Diabetology.

[29]  Paul M. Ridker,et al.  C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women , 2003 .

[30]  E. Agricola,et al.  Mitral and aortic valve sclerosis/calcification and carotid atherosclerosis: results from 1065 patients , 2014, Heart and Vessels.

[31]  B. Benzaquen,et al.  Screening for subclinical coronary artery disease measuring carotid intima media thickness. , 2009, The American journal of cardiology.

[32]  E. Oda.  Serum uric acid is an independent predictor of metabolic syndrome in a Japanese health screening population , 2014, Heart and Vessels.

[33]  L. Bouter,et al.  Metabolic Syndrome and 10-Year Cardiovascular Disease Risk in the Hoorn Study , 2005, Circulation.

[34]  A. Hofman,et al.  Predictive Value of Noninvasive Measures of Atherosclerosis for Incident Myocardial Infarction: The Rotterdam Study , 2004, Circulation.

[35]  N. Unwin,et al.  Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel on Executive Summary of the Third Report of the National , 2009 .

[36]  Lu Gao,et al.  Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data , 2012, The Lancet.

[37]  X. Jouven,et al.  Carotid intima-media thickness in plaque-free site, carotid plaques and coronary heart disease risk prediction in older adults. The Three-City Study. , 2011, Atherosclerosis.

[38]  T. Lehtimäki,et al.  Metabolic syndrome and carotid intima media thickness in the Health 2000 Survey. , 2009, Atherosclerosis.

[39]  S. Grundy,et al.  Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International As , 2009, Circulation.

[40]  B. Gulanski,et al.  Association of endogenous sex hormones and insulin resistance among postmenopausal women: results from the Postmenopausal Estrogen/Progestin Intervention Trial. , 2003, The Journal of clinical endocrinology and metabolism.

[41]  A. Hofman,et al.  Is Carotid Intima-Media Thickness Useful in Cardiovascular Disease Risk Assessment?: The Rotterdam Study , 2001, Stroke.

[42]  R. D'Agostino,et al.  Association of multiple inflammatory markers with carotid intimal medial thickness and stenosis (from the Framingham Heart Study). , 2007, The American journal of cardiology.

[43]  B. Zinman,et al.  Relationship of the metabolic syndrome to carotid ultrasound traits , 2006, Cardiovascular ultrasound.

[44]  Eary,et al.  CAROTID-ARTERY INTIMA AND MEDIA THICKNESS AS A RISK FACTOR FOR MYOCARDIAL INFARCTION AND STROKE IN OLDER ADULTS , 2000 .

[45]  R. Sacco,et al.  Metabolic Syndrome Increases Carotid Artery Stiffness: the Northern Manhattan Study , 2010, International journal of stroke : official journal of the International Stroke Society.

[46]  G. Mancia,et al.  Prevalence and incidence of the metabolic syndrome in the European Lacidipine Study on Atherosclerosis (ELSA) and its relation with carotid intima–media thickness , 2007, Journal of hypertension.

[47]  M. Hanefeld,et al.  Increased intimal-medial thickness in newly detected type 2 diabetes: risk factors. , 1999, Diabetes care.

[48]  T. Lam,et al.  Smoking cessation and carotid atherosclerosis: the Guangzhou Biobank Cohort Study—CVD , 2009, Journal of Epidemiology & Community Health.

[49]  Nancy R Cook,et al.  C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events: An 8-Year Follow-Up of 14 719 Initially Healthy American Women , 2003, Circulation.

[50]  L. Bouter,et al.  Carotid Arterial Remodeling: A Maladaptive Phenomenon in Type 2 Diabetes but Not in Impaired Glucose Metabolism: The Hoorn Study , 2004, Stroke.

[51]  Matthias W. Lorenz,et al.  Prediction of Clinical Cardiovascular Events With Carotid Intima-Media Thickness: A Systematic Review and Meta-Analysis , 2007, Circulation.

[52]  Lawrence Joseph,et al.  The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. , 2010, Journal of the American College of Cardiology.

[53]  J. Ruidavets,et al.  Metabolic syndrome is associated with markers of subclinical atherosclerosis in a French population-based sample. , 2006, Atherosclerosis.

[54]  J. Mckenney,et al.  Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). , 2001, JAMA.

[55]  A. Hirayama,et al.  Association of atherosclerosis-related markers and its relationship to n-3 polyunsaturated fatty acids levels with a prevalence of coronary artery disease in an urban area in Japan , 2013, Heart and Vessels.

[56]  M. Forouzanfar,et al.  First Nationwide Study of the Prevalence of the Metabolic Syndrome and Optimal Cutoff Points of Waist Circumference in the Middle East , 2009, Diabetes Care.