Article

The metabolic syndrome and progression of carotid atherosclerosis over 13 years. The Tromso study.

Cardiovascular Diabetology (impact factor: 3.35). 06/2012; 11(1):77. DOI:10.1186/1475-2840-11-77
Source: PubMed

ABSTRACT BACKGROUND: The metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease. In this study, we examine if metabolic syndrome predicts progression of atherosclerosis over 13 years. METHODS: Participants were 1442 men and 1532 women in the population-based Tromso Study who underwent carotid ultrasound examinations at baseline in the 4th (1994-5) and at follow-up in the 6th survey (2007-8). Of these, 278 men and 273 women fulfilled the criteria for the MetS, defined according to a modified version of the National Cholesterol Education Program Adult Treatment Panel III (NCEP, ATPIII). Carotid atherosclerosis was assessed as total plaque area (TPA) and mean intima-media thickness (IMT) at follow-up and as change in IMT and TPA from baseline to follow-up. Associations between MetS and its components and carotid atherosclerosis were assessed in linear regression models adjusted for age, total cholesterol and daily smoking, stratified by sex. RESULTS: IMT and TPA levels at follow-up (p < 0.0001) and progression of TPA (p = 0.02) were higher in the MetS group compared to the non-MetS group. In stepwise multivariable models, MetS was associated with TPA (beta = 0.372 mm2, p = 0.009) and IMT (beta = 0.051 mm, p < 0.0001) in men, and with IMT (beta = 0.045 mm, p = 0.001) in women after 13 years of follow-up, but not with progression of IMT or TPA. In analyses stratified by age, MetS predicted progression of IMT (beta = 0.043 mm, p = 0.046) and TPA (beta = 1.02 mm2, p = 0.002) in men below 50 years of age. Hypertension was predictive of follow-up TPA and IMT in both genders and of progression of TPA in women. Impaired glucose tolerance was associated with follow up levels of IMT and TPA as well as progression in IMT in men. None of the other components of MetS were associated with progression of atherosclerosis. CONCLUSIONS: Subjects with MetS had higher levels of IMT and TPA at follow up than those without MetS. Mets predicted progression of IMT and TPA in those below 50 years of age, but not in other age groups, indicating that MetS may be involved in the initiation of the atherosclerotic process.

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Keywords

6th survey
 
age groups
 
analyses stratified
 
ATPIII
 
cardiovascular disease
 
carotid atherosclerosis
 
carotid ultrasound examinations
 
follow-up TPA
 
intima-media thickness
 
linear regression models
 
metabolic syndrome
 
MetS
 
MetS group
 
modified version
 
National Cholesterol Education Program Adult Treatment Panel III
 
non-MetS group
 
stepwise multivariable models
 
total cholesterol
 
total plaque area
 
women