Department of Cardiology, Myongji Cardiovascular Center, Kwandong University College of Medicine, Goyang, Republic of Korea.
Cardiovasc Diabetol. 2013 Mar 4;12:41. doi: 10.1186/1475-2840-12-41.
Metabolic syndrome (MS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. However, data on the impact of MS and its individual components on subclinical atherosclerosis (SCA) according to diabetes status are scarce.
Surrogate markers of SCA, brachial-ankle pulse wave velocity (baPWV), and carotid intima-medial thickness (IMT) and plaque were assessed in 2,560 subjects (60 ± 8 years, 33% men) who participated in baseline health examinations for a community-based cohort study.
The participants included 2,149 non-diabetics (84%) and 411 diabetics (16%); 667 non-diabetics (31%) and 285 diabetics (69%) had MS, respectively. Diabetics had significantly higher baPWV and carotid IMT, and more plaques than non-diabetics (p < 0.001, respectively). Individuals with MS had significantly higher baPWV and carotid IMT than those without MS only among non-diabetics (p < 0.001, respectively). Among MS components, increased blood pressure was significantly associated with the exacerbation of all SCA markers in non-diabetics. The number of MS components was significantly correlated with both baPWV and carotid IMT in non-diabetics (baPWV: r = 0.302, p < 0.001; carotid IMT: r = 0.217, p < 0.001). Multiple regression showed both MS and diabetes were significantly associated with baPWV (p < 0.001, respectively), carotid IMT (MS: p < 0.001; diabetes: p = 0.005), and the presence of plaque (MS: p = 0.041; diabetes: p = 0.002).
MS has an incremental impact on SCA in conditions without diabetes. The identification of MS and its individual components is more important for the risk stratification of CVD in non-diabetic individuals.
代谢综合征（MS）与糖尿病和动脉粥样硬化性心血管疾病风险增加有关。然而，关于 MS 及其各个组成部分对糖尿病状态下亚临床动脉粥样硬化（SCA）的影响的数据却很少。
在参加基于社区的队列研究的基线健康检查的 2560 名受试者（60±8 岁，33%为男性）中，评估了 SCA 的替代标志物，包括臂踝脉搏波速度（baPWV）、颈动脉内膜中层厚度（IMT）和斑块。
参与者包括 2149 名非糖尿病患者（84%）和 411 名糖尿病患者（16%）；分别有 667 名非糖尿病患者（31%）和 285 名糖尿病患者（69%）患有 MS。糖尿病患者的 baPWV 和颈动脉 IMT 显著更高，且斑块数量也多于非糖尿病患者（p<0.001）。仅在非糖尿病患者中，患有 MS 的个体的 baPWV 和颈动脉 IMT 显著高于无 MS 的个体（p<0.001）。在 MS 成分中，血压升高与非糖尿病患者所有 SCA 标志物的恶化显著相关。在非糖尿病患者中，MS 成分的数量与 baPWV 和颈动脉 IMT 均显著相关（baPWV：r=0.302，p<0.001；颈动脉 IMT：r=0.217，p<0.001）。多元回归显示，MS 和糖尿病均与 baPWV 显著相关（p<0.001，分别）、颈动脉 IMT（MS：p<0.001；糖尿病：p=0.005）和斑块的存在（MS：p=0.041；糖尿病：p=0.002）。
MS 对无糖尿病情况下的 SCA 有累积影响。在非糖尿病个体中，识别 MS 及其各个组成部分对于 CVD 的风险分层更为重要。
