Differential impact of metabolic syndrome on subclinical atherosclerosis according to the presence of diabetes

Abstract

BackgroundMetabolic syndrome (MS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. However, data on the impact of MS and its individual components on subclinical atherosclerosis (SCA) according to diabetes status are scarce.MethodsSurrogate markers of SCA, brachial–ankle pulse wave velocity (baPWV), and carotid intima–medial thickness (IMT) and plaque were assessed in 2,560 subjects (60 ± 8 years, 33% men) who participated in baseline health examinations for a community-based cohort study.ResultsThe participants included 2,149 non-diabetics (84%) and 411 diabetics (16%); 667 non-diabetics (31%) and 285 diabetics (69%) had MS, respectively. Diabetics had significantly higher baPWV and carotid IMT, and more plaques than non-diabetics (p < 0.001, respectively). Individuals with MS had significantly higher baPWV and carotid IMT than those without MS only among non-diabetics (p < 0.001, respectively). Among MS components, increased blood pressure was significantly associated with the exacerbation of all SCA markers in non-diabetics. The number of MS components was significantly correlated with both baPWV and carotid IMT in non-diabetics (baPWV: r = 0.302, p < 0.001; carotid IMT: r = 0.217, p < 0.001). Multiple regression showed both MS and diabetes were significantly associated with baPWV (p < 0.001, respectively), carotid IMT (MS: p < 0.001; diabetes: p = 0.005), and the presence of plaque (MS: p = 0.041; diabetes: p = 0.002).ConclusionsMS has an incremental impact on SCA in conditions without diabetes. The identification of MS and its individual components is more important for the risk stratification of CVD in non-diabetic individuals.

Triglyceride glucose index is an independent predictor for the progression of coronary artery calcification in the absence of heavy coronary artery calcification at baseline

“…Park et al suggested that TyG index was an effective marker for early detecting subclinical coronary atherosclerosis even in the absence of traditional CV risk factors [40]. However, considering the inconsistent results for the association of metabolic syndrome with ASCVD in diabetic patients [41,42], further large prospective investigation for the clinical significance of TyG index in established diabetes should be necessary in diverse ethnic population.…”

Different Impacts of Cardiovascular Risk Factors on Arterial Stiffness versus Arterial Wall Thickness in Japanese Patients with Type 2 Diabetes Mellitus

“…Although its biomechanical stimuli also promotes atherogenetic changes, especially at branch points and curves 38) , the current findings indicate that ba-PWV is more influenced by elevated blood pressure than max- participant. Although this assessment was adopted in some previous studies [45][46][47][48][49][50][51] ; others assessed ba-PWV as the mean of the two measurements [52][53][54] or the measurement on one specific side (e.g., the right side) 55,56) . Future studies will be needed to investigate whether similar findings would be obtained when these assessments were used instead of selecting the higher value.…”

Hypertriglyceridemia: a too long unfairly neglected major cardiovascular risk factor

“…Hypertriglyceridemia, as one of the components of the MS, is closely related to a constellation of metabolic risk factors including a central distribution of adiposity or visceral obesity, insulin resistance, impaired glucose tolerance, hypertension, and high TG and/or low HDL-C, associated with an atherogenic, procoagulant, and proinflammatory state [56][57][58][59][60][61][62][63][64].…”