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

Herder M, Arntzen KA, Johnsen SH, Mathiesen EB - Cardiovasc Diabetol (2012)

Bottom Line: 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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Community Medicine, University of Tromsø, Tromsø, Norway. marit.herder@uit.no

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 Tromsø 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 (β = 0.372 mm2, p = 0.009) and IMT (β = 0.051 mm, p < 0.0001) in men, and with IMT (β = 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 (β = 0.043 mm, p = 0.046) and TPA (β = 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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a: Change in IMT in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals. b: Change in TPA in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals.
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Figure 2: a: Change in IMT in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals. b: Change in TPA in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals.

Mentions: Mean observation time was 13.2 years. Follow-up levels of IMT and TPA were higher in subjects with MetS than in controls, most pronounced in those below 70 years of age. Change in IMT and TPA was associated with Mets only in those younger than 50 years (Table 2, Figures1 and2).


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

Herder M, Arntzen KA, Johnsen SH, Mathiesen EB - Cardiovasc Diabetol (2012)

a: Change in IMT in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals. b: Change in TPA in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539868&req=5

Figure 2: a: Change in IMT in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals. b: Change in TPA in subjects with and without metabolic syndrome (MetS), by age group. Error bars represent 95% confidence intervals.
Mentions: Mean observation time was 13.2 years. Follow-up levels of IMT and TPA were higher in subjects with MetS than in controls, most pronounced in those below 70 years of age. Change in IMT and TPA was associated with Mets only in those younger than 50 years (Table 2, Figures1 and2).

Bottom Line: 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.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Community Medicine, University of Tromsø, Tromsø, Norway. marit.herder@uit.no

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 Tromsø 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 (β = 0.372 mm2, p = 0.009) and IMT (β = 0.051 mm, p < 0.0001) in men, and with IMT (β = 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 (β = 0.043 mm, p = 0.046) and TPA (β = 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.

Show MeSH
Related in: MedlinePlus