Iglseder Bernhard, Cip Paula, Malaimare Liane, Ladurner Gunther, Paulweber Bernhard
Department of Neurology, Christian-Doppler-Klinik, Salzburg, Austria.
Stroke. 2005 Jun;36(6):1212-7. doi: 10.1161/01.STR.0000166196.31227.91. Epub 2005 May 12.
The metabolic syndrome (MetS) is associated with an increased risk for subsequent development of type 2 diabetes mellitus, cardiovascular disease, and stroke. Type 2 diabetes increases the risk of stroke and coronary heart disease in women to a greater extent than in men, and thus the question arises whether there are sex differences in the association of early atherosclerosis and MetS.
1588 middle-aged Austrian subjects (1001 males, 587 females) were included in the present study. MetS was defined by the criteria of the National Cholesterol Education Program Adult Treatment Panel III. Early atherosclerosis was assessed by intima-media thickness (IMT) and extent of plaques (B-score) of the carotid arteries.
B-score and carotid artery IMT parameters were significantly higher in subjects with the MetS. After adjustment for established risk factors, the difference in B-score remained significant only in women. Computed common carotid artery IMT values using general linear model equations with age, body mass index, and low-density lipoprotein cholesterol as covariates displayed the highest values for men with MetS (811.8+/-9.5 microm). Women with MetS (797.6+/-15 microm) and men without the syndrome (788.8+/-5 microm) showed similar IMTs, whereas women without the MetS presented significantly lower values (735.6+/-7 microm). Among the subcomponents of the MetS, high-density lipoprotein cholesterol showed the strongest impact on IMT in men, whereas blood glucose ranked first in women.
The effect of MetS on early atherosclerosis is more pronounced in females. The impact of the components of MetS on carotid IMT differs between men and women.
代谢综合征（MetS）与后续发生2型糖尿病、心血管疾病及中风的风险增加相关。2型糖尿病在女性中比在男性中更易增加中风和冠心病的风险，因此出现了早期动脉粥样硬化与MetS之间的关联是否存在性别差异的问题。
本研究纳入了1588名奥地利中年受试者（男性1001名，女性587名）。MetS根据美国国家胆固醇教育计划成人治疗专家组第三次报告的标准进行定义。通过颈动脉内膜中层厚度（IMT）和斑块范围（B评分）评估早期动脉粥样硬化。
患有MetS的受试者的B评分和颈动脉IMT参数显著更高。在对既定风险因素进行调整后，仅在女性中B评分的差异仍具有统计学意义。使用以年龄、体重指数和低密度脂蛋白胆固醇作为协变量的一般线性模型方程计算的颈总动脉IMT值显示，患有MetS的男性最高（811.8±9.5微米）。患有MetS的女性（797.6±15微米）和未患该综合征的男性（788.8±5微米）显示出相似的IMT值，而未患MetS的女性IMT值显著更低（735.6±7微米）。在MetS的各亚组分中，高密度脂蛋白胆固醇对男性的IMT影响最大，而血糖在女性中影响最大。
MetS对早期动脉粥样硬化的影响在女性中更为明显。MetS各组分对颈动脉IMT的影响在男性和女性之间存在差异。
