Metabolic syndrome is associated with markers of subclinical atherosclerosis in a French population-based sample

Ahluwalia, Namanjeet; Drouet, Ludovic; Ruidavets, Jean Bernard; Perret, Bertrand; Amar, Jacques; Boccalón, H; Hanaire-Broutin, H; Ferrières, Jean

doi:10.1016/j.atherosclerosis.2005.07.021

Cited by 86 publications

(84 citation statements)

References 43 publications

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“…The independent yet relatively minor contributions of glucose indices to cf PWV variance correspond with previous studies [14][15][16] and are predictable given the nature of variables entered into the multivariate analysis. Ageing inevitably dominates determinants of haemodynamic structure and function because of its profound effects on vascular wall integrity, rheology and central aortic pressure.…”

Section: Resultssupporting

confidence: 82%

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Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity

et al. 2010

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Aims/hypothesis Non-invasive measures of aortic stiffness reflect vascular senescence and predict outcome in diabetes. Glucose-mediated elastic artery sclerosis may play an integral role in the development of macrovascular complications. We used carotid-femoral pulse wave velocity ( cf PWV) to quantify independent associations of fasting glucose, post-challenge glucose and derived insulin resistance (HOMA-IR) with aortic stiffness. Methods cf PWV was measured using a 4 MHz continuous wave Doppler ultrasound probe within groups with newly identified age-and sex-matched normal glucose metabolism (NGM), impaired glucose regulation (IGR) and diabetes mellitus populations (n=570, mean age 59.1, 56% male). Results After multivariate adjustment, IGR and diabetes were associated with significant aortic stiffening compared with NGM (adjusted cf PWV±SE: NGM, 9.15±0.12 m/s; IGR 9.76±0.11 m/s, p<0.001; diabetes, 9.89±0.12 m/s, p< 0.001). IGR stratification indicated that impaired fasting glucose (IFG; 9.71±0.12 m/s) and post-challenge (impaired glucose tolerance; 9.82±0.24 m/s) categories had similar cf PWV (p=0.83). Modelled predictors of cf PWV were used to assess independent metabolic associations with arterial stiffness. Fasting glucose concentration (β=0.10; 95% CI 0.05, 0.18; p=0.003), 2 h post-challenge glucose (β=0.14; 95% CI 0.02, 0.23; p<0.001) and HOMA-IR (β=0.20, 95% CI 0.05, 0.53; p<0.001) were independently related to cf PWV after adjustment for age, sex, mean arterial pressure, heart rate, body mass index, renal function and antihypertensive medication. Conclusions/interpretation IGR characterised by fasting or post-challenge hyperglycaemia is associated with significant vascular stiffening. Post-challenge glucose and HOMA-IR are the most powerful metabolic predictors of arterial stiffness, implying hyperglycaemic excursion and insulin resistance play important roles in the pathogenesis of arteriosclerosis.

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Section: Resultssupporting

confidence: 82%

“…These relationships are reported individually [11][12][13] or as a cumulative effect of the metabolic syndrome. [14][15][16][17][18][19] and do not specifically address the relative independent strengths of FPG and 2-HPG associations with measures of arterial stiffness.…”

Section: Introductionmentioning

confidence: 99%

Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity

et al. 2010

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“…An independent association between MS and arterial stiffness as measured by various techniques including pulse-wave velocity and arterial distensibility has already been described in cross-sectional studies, especially in middle-aged and elderly patients. 16,17 More recently, Safar et al 18 demonstrated that the presence of MS entails an increased progression of age-related arterial stiffness, thus fostering an acceleration of the ageing process. The novelty of our findings resides in the fact that this is the first evidence of the association between MS and AASI, a recently proposed index of arterial stiffness.…”

Section: Discussionmentioning

confidence: 99%

Metabolic syndrome and ambulatory arterial stiffness index in non-diabetic patients with primary hypertension

et al. 2007

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Increased arterial stiffness and the presence of metabolic syndrome (MS) have been shown to predict cardiovascular events in patients with primary hypertension. We investigated the relationship between a recently proposed index of arterial stiffness derived from ambulatory blood pressure (BP) monitoring and MS in 156 untreated, non-diabetic patients with primary hypertension. Ambulatory arterial stiffness index (AASI) was defined as 1 minus the regression slope of diastolic over systolic BP readings obtained from 24-h recordings. A modified National Cholesterol Education Program definition for MS was used, with body mass index replacing waist circumference. The prevalence of MS was 23%. Patients with MS were more frequently male (0.0291) and had increased serum uric acid (P ¼ 0.0005), high-sensitivity C-reactive protein (P ¼ 0.0259), as well as total and low-density lipoprotein (LDL)-cholesterol (P ¼ 0.0374 and P ¼ 0.0350, respectively) as compared to those without MS. After adjusting for these confounders, the association between AASI and the presence of MS was statistically significant (P ¼ 0.0257). Moreover, the prevalence of increased AASI (upper tertile, that is X0.550) was greater in patients with MS (P ¼ 0.0156). After adjusting for age and 24-h mean BP, the presence of MS entailed a more than twofold greater risk for increased AASI (0.0280). MS is associated with increased AASI in non-diabetic patients with primary hypertension. These data support the role of this new index of arterial stiffness as a marker of risk and help to explain the high cardiovascular morbidity and mortality that is observed in hypertensive patients with MS.

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“…3 The term arterial stiffness refers to an impairment in the cushioning function of the artery (that is, a diminished ability to convert the pulsatile blood flow from the heart into a steady and continuous stream throughout the arterial tree), which leads to increased systolic blood pressure, left ventricular hypertrophy, impaired coronary perfusion and arterial stiffness-associated CVD (notably, stroke, heart failure and myocardial infarction), 4 and can be measured both locally (at a single location within the artery wall) or regionally (over a prespecified arterial segment, for example, the carotid-femoral tract). Earlier studies on arterial stiffness in the MetS [5][6][7][8][9][10][11][12][13][14][15][16] have raised several issues. Firstly, there is some evidence that, in the MetS, increases in arterial stiffness may not be uniformly distributed over muscular (that is, peripheral) and elastic (that is, central) arteries.…”

Section: Introductionmentioning

confidence: 99%

“…Firstly, there is some evidence that, in the MetS, increases in arterial stiffness may not be uniformly distributed over muscular (that is, peripheral) and elastic (that is, central) arteries. 7,8,13 The interpretation of the literature, however, is hampered by the fact that most studies reported arterial stiffness in only one site [14][15][16] or segment, 5,6,[9][10][11][12] whereas studies that did report on multiple sites 8 or segments 7,13 showed discordant results. Secondly, the MetS is associated with insulin resistance (IR), a proinflammatory state and endothelial dysfunction (ED), 17 and it has been suggested that these phenomena play an important role in the complex pathobiology of arterial stiffening.…”

Section: Introductionmentioning

confidence: 99%

The metabolic syndrome in elderly individuals is associated with greater muscular, but not elastic arterial stiffness, independent of low-grade inflammation, endothelial dysfunction or insulin resistance—The Hoorn Study

et al. 2009

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The metabolic syndrome (MetS) increases cardiovascular disease (CVD) risk. How MetS increases CVD risk is incompletely understood, but increasing arterial stiffness is one candidate link, which in turn could be explained by (low-grade) inflammation, endothelial dysfunction (ED) or insulin resistance (IR). However, MetSrelated increases in stiffness may not be uniformly distributed over muscular and elastic arteries. Therefore, the purpose of this study was to determine: (1) the associations between the MetS, and muscular and elastic arterial stiffness, and (2) whether any such associations could be explained by inflammation, ED or IR. These questions were addressed in the Hoorn Study. MetS was defined according to the NCEP (National Cholesterol Education Program) criteria. Arterial stiffness was determined by ultrasound, tonometry and echocardiography. Inflammation, ED and IR were estimated by C-reactive protein, flow-mediated vasodilation and the homoeostatic model for the assessment of IR, respectively. The results showed that MetS was associated with both femoral and brachial arterial stiffness, significantly so for the distensibility coefficients and for the femoral compliance coefficient. In the carotid artery and aorta, no particular pattern emerged. Additional adjustment for either inflammation, ED or IR did not materially alter the results. The results therefore indicate that muscular arteries may stiffen preferentially over elastic arteries and that distensibility is affected to a greater extent than compliance, thus maintaining volume compliance over vessel wall stiffening. Additionally, the increase in stiffness was not explained by inflammation, ED or IR and suggests that stiffening of the muscular arteries in MetS may not be the consequence of these phenomena.

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Metabolic syndrome is associated with markers of subclinical atherosclerosis in a French population-based sample

Cited by 86 publications

References 43 publications

Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity

Impact of metabolic indices on central artery stiffness: independent association of insulin resistance and glucose with aortic pulse wave velocity

Metabolic syndrome and ambulatory arterial stiffness index in non-diabetic patients with primary hypertension

The metabolic syndrome in elderly individuals is associated with greater muscular, but not elastic arterial stiffness, independent of low-grade inflammation, endothelial dysfunction or insulin resistance—The Hoorn Study

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