CLINICAL RESEARCH: ATHEROSCLEROTIC RISK FACTORS
Metabolic syndrome amplifies the age-associated increases in vascular thickness and stiffness
Angelo Scuteri, MD, PhD* ,*,
Samer S. Najjar, MD*,
Denis C. Muller, MS*,
Reubin Andres, MD*,
Hidetaka Hougaku, MD*,
E. Jeffrey Metter, MD* and
Edward G. Lakatta, MD*
* Laboratory of Cardiovascular Science, Laboratory of Clinical Investigation, Gerontology Research Center, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
U.O. Geriatria, INRCA, Rome, Italy
Manuscript received July 3, 2003;
revised manuscript received September 6, 2003,
accepted October 20, 2003.
* Reprint requests and correspondence: Dr. Angelo Scuteri, Laboratory of Cardiovascular Science, National Institute on Aging, National Institutes of Health, 5600 Nathan Shock Drive, Baltimore, Maryland 21224-6825, USA.
Scuteria{at}grc.nia.nih.gov
OBJECTIVES: We sought to evaluate whether the clustering of multiple components of the metabolic syndrome (MS) has a greater impact on these vascular parameters than individual components of MS.
BACKGROUND: Intima-media thickness (IMT) and vascular stiffness have been shown to be independent predictors of adverse cardiovascular events. The MS is defined as the clustering of three or more of the cardiovascular risk factors of dysglycemia, hypertension, dyslipidemia, and obesity.
METHODS: Carotid IMT and stiffness were derived via B-mode ultrasonography in 471 participants from the Baltimore Longitudinal Study on Aging, who were without clinical cardiovascular disease and not receiving antihypertensive therapy.
RESULTS: The MS conferred a disproportionate increase in carotid IMT (+16%, p < 0.0001) and stiffness (+32%, p < 0.0001), compared with control subjects. Multiple regression models, which included age, gender, smoking, low-density lipoprotein, as well as each individual component of MS as continuous variables, showed that MS was an independent determinant of both IMT (p = 0.002) and stiffness (p = 0.012). The MS was associated with a greater prevalence of subjects whose values were in the highest quartiles of IMT, stiffness, or both.
CONCLUSIONS: Even after taking into account each individual component of MS, the clustering of at least three of these components is independently associated with increased IMT and stiffness. This suggests that the components of MS interact to synergistically impact vascular thickness and stiffness. Future studies should examine whether the excess cardiovascular risk associated with MS is partly mediated through the amplified alterations in these vascular properties.
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Abbreviations and Acronyms
| | AGEPs | = advanced glycation end products | | BLSA | = Baltimore Longitudinal Study of Aging | | BP | = blood pressure | | CCA | = common carotid artery | | DBP | = diastolic blood pressure | | HDL | = high-density lipoprotein | | IMT | = intima-media thickness | | LDL | = low-density lipoprotein | | MS | = metabolic syndrome | | SBP | = systolic blood pressure |
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