Vascular Impact of Metabolic Syndrome in Subjects with Normal Weight, Overweight, or Obesity: Is Normal Weight Sufficient for Vascular Health?

OBJECTIVE

Obesity appears to be one of the major risk factors for metabolic complications. However, no direct relationship between body weight and metabolic abnormalities exists. The present study was designed to investigate the impact of body mass index (BMI) and the presence of metabolic syndrome (MS) on early vascular atherosclerotic changes, as determined by augmentation index (AI) and pulse wave velocity (PWV).

DESIGN AND METHODS

The 285 study participants were divided into four groups according to BMI and the presence of MS. Subjects without MS were defined as metabolically normal, while subjects with MS were defined as metabolically obese. Group 1 included 71 metabolically normal, normal-weight subjects (MNNW), Group 2 included 69 metabolically obese, normal-weight subjects (MONW), Group 3 included 66 metabolically obese, overweight subjects (MOOW), and Group 4 included 79 metabolically obese, obese subjects (MOOB).

RESULTS

AI and PWV differed significantly between groups, such that they increased from Group 1 to Group 4 in a continuous fashion. AI was significantly lower in normal-weight subjects without MS than in normal-weight subjects with MS (p < 0.001). In univariate general linear model (GLM) analysis, significant by-group differences in AI persisted even after adjustment for age, sex, and blood pressure.

CONCLUSIONS

AI was significantly higher in normal-weight subjects with MS than in normal-weight metabolically benign individuals. Thus, even in patients with normal weight (BMI ≤ 25), presence of metabolic syndrome was associated with significant deterioration in terms of arterial stiffness.