Neck and brain vascular impairment in a group of patients with metabolic syndrome

Abstract

Background. Metabolic syndrome (MetS) is an entity with proved involvement in cardiovascular pathology. We aim to highlight the existing type of cerebrovascular damage in a group of patients with MetS by comparison to the control group. Method. We analyzed 36 patients with MetS (defined according to NCEP:ATP III 2001 criteria) and a number of 25 subjects that represented the control group, aged between 40 and 67 years old, that had no personal history of cardiovascular or cerebrovascular disease. The subjects were clinically-neurologically and metabolically evaluated, as well as biochemical and haematologically explored. Neck and brain vascular impairment (IMT and atheromatous plaques measurement, cerebral vasoreactivity) was highlighted using cervical and transcranial neurosonology (including performing the apnea test). The obtained results were statistically processed. Results. Patients with MetS had higher average IMT than control (0.62 mm to 0.54 mm) as well as a higher percentage of atheromatous plaques 25% (9/36) when compared to the control group 20% (5/25). Cerebral vasoreactivity impairment was equal 52.8% (19/36) in MetS patients and 52% (13/25) in control group subjects. None of these differences was statistically significant. In patients with MetS the average IMT was correlated with the existence of atheromatous plaques (p = 0.023) and other associated risk factors like arterial hypertension & smoking (p = 0.018), dyslipidemia & obesity (p = 0.003), smoking & increased abdominal circumference (p = 0.049). For the control group the existence of atheromatous plaques was correlated with smoking status (p = 0.027). Conclusions. Even though the neck and brain vessels impairment was better expressed in the MetS patients group, there is no a statistically significant correlation. In MetS patients presence of different combinations of vascular risk factors determines strong associations with increased IMT.