Nutritional Epidemiology Research Unit, UMR U557 INSERM, U1125 INRA, CNAM, Paris 13, CRNH-IdF, Bobigny, France.
Hypertens Res. 2010 Apr;33(4):293-7. doi: 10.1038/hr.2009.228. Epub 2010 Jan 15.
The metabolic syndrome (MetS) is associated with increased risk of type-2 diabetes and cardiovascular disease (CVD). We hypothesized that both small and large arteries may be impaired in subjects with the MetS, even in the absence of known CVD or diabetes. We compared both skin capillary density (CD) and pulse-wave velocity (PWV) in 36 cases with the MetS with those from 108 age- and gender-matched controls from the SU.VIM.AX-2 cohort. Compared with controls, MetS subjects demonstrated increased PWV (12.2+/-2.8 vs. 10.7+/-1.9 m s(-1), P=0.005) and lower functional CD (83.1+/-15.7 vs. 89.4+/-14.2 capillaries per mm(2), P=0.03). Functional CD was inversely related to fasting glucose, triglycerides (TGs) and HOMA-IR (all P<0.05). On the other hand, no association was found between CD and BP or with PWV. In multivariate models, the odds ratios (95% confidence interval) for one standard deviation change, for having an impaired PWV (>or=12 m s(-1), n=44), were: 1.65 (1.11-2.45) for systolic BP and 1.93 (1.25-2.99) for TG only. For impaired CD (<or=80 capillaries per mm(2)), the odds ratios (95% confidence interval) were 1.45 (1.00-2.08) for TG and 1.65 (1.13-2.43) for fasting glucose, only. In conclusion, MetS subjects exhibited evidence of macro- and microcirculatory dysfunction, even in the absence of diabetes and CVD. The common mechanism linking MetS components to CVD risk through small- and large-artery dysfunctions may be mediated through metabolic factors related to insulin resistance, not to increased BP.
代谢综合征（MetS）与 2 型糖尿病和心血管疾病（CVD）风险增加相关。我们假设，即使在没有已知 CVD 或糖尿病的情况下，代谢综合征患者的小动脉和大动脉都可能受损。我们比较了 SU.VIM.AX-2 队列中 36 例代谢综合征患者和 108 例年龄和性别匹配的对照者的皮肤毛细血管密度（CD）和脉搏波速度（PWV）。与对照组相比，代谢综合征患者的 PWV 更高（12.2+/-2.8 对 10.7+/-1.9 m s(-1)，P=0.005），功能性 CD 更低（83.1+/-15.7 对 89.4+/-14.2 个毛细血管/毫米 2，P=0.03）。功能性 CD 与空腹血糖、甘油三酯（TGs）和 HOMA-IR 呈负相关（均 P<0.05）。另一方面，CD 与 BP 或 PWV 之间没有关联。在多变量模型中，PWV 异常（>or=12 m s(-1)，n=44）的优势比（95%置信区间）为：收缩压每增加一个标准差的 1.65（1.11-2.45）和 TG 为 1.93（1.25-2.99）。对于 CD 异常（<or=80 个毛细血管/毫米 2），TG 的优势比（95%置信区间）为 1.45（1.00-2.08），空腹血糖为 1.65（1.13-2.43）。总之，即使在没有糖尿病和 CVD 的情况下，代谢综合征患者也表现出大、小血管功能障碍的证据。将代谢综合征成分与 CVD 风险联系起来的共同机制可能是通过与胰岛素抵抗相关的代谢因素介导的，而不是通过增加的 BP 介导的。
