Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL 33101, USA.
Int J Stroke. 2010 Jun;5(3):138-44. doi: 10.1111/j.1747-4949.2010.00421.x.
Arterial stiffness, an intermediate pre-clinical marker of atherosclerosis, has been associated with an increased risk of stroke and cardiovascular disease. The metabolic syndrome and its components are established cardiovascular disease risk factors and may also increase arterial stiffness; however, data regarding this are limited.
The goal of this study was to determine the association between the metabolic syndrome and carotid artery stiffness in an elderly multi-ethnic cohort.
Carotid artery stiffness was assessed by carotid ultrasound as part of the Northern Manhattan Study, a prospective population-based cohort of stroke-free individuals. Carotid artery stiffness was calculated as [ln(systolic BP/diastolic BP)/strain], where strain was [(systolic diameter-diastolic diameter)/diastolic diameter]. Metabolic syndrome was defined by the National Cholesterol Education Program: Adult Treatment Panel III criteria. LogSTIFF was analysed as the dependent variable in linear regression models, adjusting for demographics, education, current smoking, presence of carotid plaque and intima-media thickness.
Carotid artery stiffness was analysed in 1133 Northern Manhattan Study subjects (mean age 65 +/- 9 years; 61% women; 58% Hispanic, 22% Black and 20% Caucasian). The prevalence of the metabolic syndrome was 49%. The mean LogSTIFF was 2.01 +/- 0.61 among those with the metabolic syndrome and 1.90 +/- 0.59 among those without the metabolic syndrome (P=0.003). The metabolic syndrome was significantly associated with increased logSTIFF in the final adjusted model (parameter estimate beta=0.100, P=0.01). Among individual metabolic syndrome components, waist circumference and elevated blood pressure were most significantly associated with a mean increase in logSTIFF (P<0.01).
The metabolic syndrome is significantly associated with increased carotid artery stiffness in a multiethnic population. Increased carotid artery stiffness may, in part, explain a high risk of stroke among individuals with the metabolic syndrome.
动脉僵硬度是动脉粥样硬化的一种中间临床前标志物，与中风和心血管疾病的风险增加有关。代谢综合征及其成分是已确立的心血管疾病危险因素，也可能增加动脉僵硬度；然而，这方面的数据有限。
本研究的目的是确定在一个多民族队列中代谢综合征与颈动脉僵硬度之间的关系。
颈动脉僵硬度通过颈动脉超声评估，作为无中风的北曼哈顿研究的一部分，这是一项前瞻性的基于人群的队列研究。颈动脉僵硬度通过以下公式计算：[ln（收缩压/舒张压）/应变]，其中应变等于[(收缩直径-舒张直径）/舒张直径]。代谢综合征通过国家胆固醇教育计划：成人治疗小组 III 标准定义。对数颈动脉僵硬度（LogSTIFF）作为线性回归模型中的因变量进行分析，调整了人口统计学、教育、当前吸烟、颈动脉斑块和内膜中层厚度的因素。
在 1133 名北曼哈顿研究参与者中分析了颈动脉僵硬度（平均年龄 65 +/- 9 岁；61%为女性；58%为西班牙裔，22%为黑人，20%为白人）。代谢综合征的患病率为 49%。患有代谢综合征的参与者的平均 LogSTIFF 为 2.01 +/- 0.61，而没有代谢综合征的参与者为 1.90 +/- 0.59（P=0.003）。在最终调整后的模型中，代谢综合征与 LogSTIFF 的增加显著相关（参数估计β=0.100，P=0.01）。在单个代谢综合征成分中，腰围和血压升高与 LogSTIFF 的平均增加最显著相关（P<0.01）。
在一个多民族人群中，代谢综合征与颈动脉僵硬度的增加显著相关。颈动脉僵硬度的增加可能部分解释了代谢综合征患者中风风险高的原因。
