The online version of this article (doi:10.1186/1475-2840-11-77) contains supplementary material, which is available to authorized users.
An erratum to this article is available at http://dx.doi.org/10.1186/1475-2840-12-144.
We declare that we have no competing interests.
MH acquired the carotid ultrasound data, performed the statistical analysis, and drafted the manuscript. KAA acquired the carotid ultrasound data, and made critical revision of the manuscript. SHJ participated in the design of the study, and made critical revision of the manuscript. EBM designed and coordinated the study, acquired the carotid ultrasound data, handled funding, and helped to draft the manuscript. All authors read and approved the final manuscript.
The metabolic syndrome (MetS) is associated with increased risk of cardiovascular disease. In this study, we examine if metabolic syndrome predicts progression of atherosclerosis over 13 years.
Participants were 1442 men and 1532 women in the population-based Tromsø Study who underwent carotid ultrasound examinations at baseline in the 4th (1994–5) and at follow-up in the 6th survey (2007–8). Of these, 278 men and 273 women fulfilled the criteria for the MetS, defined according to a modified version of the National Cholesterol Education Program Adult Treatment Panel III (NCEP, ATPIII). Carotid atherosclerosis was assessed as total plaque area (TPA) and mean intima-media thickness (IMT) at follow-up and as change in IMT and TPA from baseline to follow-up. Associations between MetS and its components and carotid atherosclerosis were assessed in linear regression models adjusted for age, total cholesterol and daily smoking, stratified by sex.
IMT and TPA levels at follow-up (p < 0.0001) and progression of TPA (p = 0.02) were higher in the MetS group compared to the non-MetS group. In stepwise multivariable models, MetS was associated with TPA (β = 0.372 mm2, p = 0.009) and IMT (β = 0.051 mm, p < 0.0001) in men, and with IMT (β = 0.045 mm, p = 0.001) in women after 13 years of follow-up, but not with progression of IMT or TPA. In analyses stratified by age, MetS predicted progression of IMT (β = 0.043 mm, p = 0.046) and TPA (β = 1.02 mm2, p = 0.002) in men below 50 years of age. Hypertension was predictive of follow-up TPA and IMT in both genders and of progression of TPA in women. Impaired glucose tolerance was associated with follow up levels of IMT and TPA as well as progression in IMT in men. None of the other components of MetS were associated with progression of atherosclerosis.
Subjects with MetS had higher levels of IMT and TPA at follow up than those without MetS. Mets predicted progression of IMT and TPA in those below 50 years of age, but not in other age groups, indicating that MetS may be involved in the initiation of the atherosclerotic process.
Ballantyne CM, Hoogeveen RC, McNeill AM, Heiss G, Schmidt MI, Duncan BB, Pankow JS: Metabolic syndrome risk for cardiovascular disease and diabetes in the ARIC study. Int J Obes. 2008, 32 (Suppl 2): S21-S24. CrossRef
Sipila K, Moilanen L, Nieminen T, Reunanen A, Jula A, Salomaa V, Kaaja R, Kukkonen-Harjula K, Lehtimaki T, Kesaniemi YA, et al: Metabolic syndrome and carotid intima media thickness in the Health 2000 Survey. Atherosclerosis. 2009, 204 (1): 276-281. 10.1016/j.atherosclerosis.2008.08.029. CrossRefPubMed
Galassi A, Reynolds K, He J: Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. American J Med. 2006, 119 (10): 812-819. 10.1016/j.amjmed.2006.02.031. CrossRef
Kawamoto R, Tomita H, Inoue A, Ohtsuka N, Kamitani A: Metabolic syndrome may be a risk factor for early carotid atherosclerosis in women but not in men. J of Atheroscl Thromb. 2007, 14 (1): 36-43. 10.5551/jat.14.36. CrossRef
Koskinen J, Kahonen M, Viikari JS, Taittonen L, Laitinen T, Ronnemaa T, Lehtimaki T, Hutri-Kahonen N, Pietikainen M, Jokinen E, et al: Conventional cardiovascular risk factors and metabolic syndrome in predicting carotid intima-media thickness progression in young adults: the cardiovascular risk in young Finns study. Circulation. 2009, 120 (3): 229-236. 10.1161/CIRCULATIONAHA.108.845065. CrossRefPubMed
Jacobsen BK, Eggen AE, Mathiesen EB, Wilsgaard T, Njølstad I: Cohort profile: The Tromsø Study. IntJ Epidemiol. 2011, e-pub ahead of print: 10.1093/ije/dyr049
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, et al: Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Curr Opin Cardiol. 2006, 21 (1): 1-6. 10.1097/01.hco.0000200416.65370.a0. CrossRefPubMed
Borch KH, Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB: Abdominal obesity is essential for the risk of venous thromboembolism in the metabolic syndrome: the Tromsø Study. J Tromb Haemost . 2009, 7 (5): 739-745. 10.1111/j.1538-7836.2008.03234.x. CrossRef
Liang Q, Wendelhag I, Wikstrand J, Gustavsson T: A multiscale dynamic programming procedure for boundary detection in ultrasonic artery images. Trans Med Imaging. 2000, 19 (2): 127-142. 10.1109/42.836372. CrossRef
Fosse E, Johnsen SH, Stensland-Bugge E, Joakimsen O, Mathiesen EB, Arnesen E, Njølstad I: Repeated visual and computer-assisted carotid plaque characterization in a longitudinal population-based ultrasound study: the Tromso study. Ultrasound Med Biol. 2006, 32 (1): 3-11. 10.1016/j.ultrasmedbio.2005.09.006. CrossRefPubMed
Zanchetti A, Hennig M, Baurecht H, Tang R, Cuspidi C, Carugo S, Mancia G: Prevalence and incidence of the metabolic syndrome in the European Lacidipine Study on Atherosclerosis (ELSA) and its relation with carotid intima-media thickness. Hypertens. 2007, 25 (12): 2463-2470. 10.1097/HJH.0b013e3282f063d5. CrossRef
Ikonomidis I, Kadoglou N, Tsiotra PC, Kollias A, Palios I, Fountoulaki K, Halvatsiotis I, Maratou E, Dimitriadis G, Kremastinos DT, et al: Arterial Stiffness Is Associated With Increased Monocyte Expression of Adiponectin Receptor mRNA and Protein in Patients With Coronary Artery Disease. Am J Hypertens. 2012, 10.1038/ajh.2012.42. e-pub ahead of print.
- The metabolic syndrome and progression of carotid atherosclerosis over 13 years. The Tromsø study
Kjell Arne Arntzen
Stein Harald Johnsen
Ellisiv B Mathiesen
- BioMed Central
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