Arterial stiffness and its association with clustering of metabolic syndrome risk factors

Author(s)

Lopes-Vicente, Wanda R. P. ^[1] ; Rodrigues, Sara ^[2] ; Cepeda, Felipe X. ^[2] ; Jordao, Camila Paixao ^[2] ; Costa-Hong, Valeria ^[2] ; Dutra-Marques, Akothirene C. B. ^[2] ; Carvalho, Jefferson C. ^[2] ; Alves, Maria Janieire N. N. ^[2] ; Bortolotto, Luiz A. ^[2] ; Trombetta, Ivani C. ^[1]

Affiliation

^[1] Univ Nove de Julho UNINOVE, Programa Pos Grad Med, Rua Vergueiro 235-249, BR-01504001 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Heart Inst InCor, Hosp Clin, Fac Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: DIABETOLOGY & METABOLIC SYNDROME; v. 9, OCT 25 2017.
• Web of Science Citations: 9

Abstract

Background: Metabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients. Methods: Recently diagnosed and untreated patients with MetS (n = 64, 49 +/- 8 year, 32 +/- 4 kg/m(2)) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 +/- 6 year, 27 +/- 2 kg/m(2)). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations. Results: Patients with MetS had increased PWV when compared to Control (7.8 +/- 1.1 vs. 7.0 +/- 0.5 m/s, p < 0.001). In multivariate analysis, the variables that remained as predictors of PWV were age (beta = 0.450, p < 0.001), systolic blood pressure (beta = 0.211, p = 0.023) and triglycerides (beta = 0.212, p = 0.037). The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 +/- 0.4 vs. 7.5 +/- 0.2, p = 0.011 and 7.2 +/- 0.3 m/s, p = 0.012). Similarly, the 4 risk factors group had higher PWV than the Control (7.9 +/- 0.2 vs. 7.2 +/- 0.3, p = 0.047). Conclusions: The number of risk factors seems to increase arterial stiffness. Notably, besides age and increased systolic blood pressure, alterations in the triglycerides worsened the stiffness of large vessels, emphasizing the importance in addressing this risk factor in MetS patients. (AU)

• FAPESP's process: 11/17533-6 - Autonomic, metabolic and inflammatory aspects of metabolic syndrome associated with obstructive sleep apnea: effect of hypocaloric diet and physical training
• Grantee: Ivani Credidio Trombetta
• Support Opportunities: Regular Research Grants
• FAPESP's process: 16/16831-7 - Metabolic/inflammatory markers and sympatho-vagal balance in patients with metabolic syndrome and obstructive sleep apnea: effect of hypocaloric diet and exercise training
• Grantee: Felipe Xerez Cepêda Fonseca
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 13/15323-0 - Arterial stiffness and vascular resistance in patients with metabolic syndrome: effect of hypocaloric diet associated with exercise training
• Grantee: Sara Rodrigues
• Support Opportunities: Scholarships in Brazil - Master