Association between carotid intima media thickness and metabolic syndrome
DOI:
https://doi.org/10.18203/2349-3933.ijam20184765Keywords:
Atherosclerosis, Carotid intima media thickness, Metabolic syndromeAbstract
Background: Metabolic syndrome and its individual criteria pose a risk for atherosclerosis and cardiovascular disease (CVD). Carotid intima media thickness (CIMT) is a well-known marker of subclinical atherosclerosis. This study was aimed to assess CIMT in patients with metabolic syndrome.
Methods: This one year cross-sectional study was conducted in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2016 to December 2016. A total of 100 patients diagnosed to have metabolic syndrome based on national cholesterol education program adult treatment panel III (NCEP ATP III) criteria were studied. All the patients were subjected to carotid B mode ultrasonography.
Results: The most common age group was 51 to 60years (29%). Out of 100 individuals who were diagnosed to have metabolic syndrome, 60% had five criteria, 29% had four criteria and 3% had three criteria. Most of the of the individuals (61.00%) had normal (≤0.10cms) CIMT while high (>0.10cm) levels were noted in 39.00% of the individuals. The mean CIMT was noted as 0.13±0.16cms. The mean SBP (150.15±10.39 vs 142.98±20.09mmHg; p=0.042), DBP (94.51±6.53 vs 90.16±9.91 mmHg; p=0.017), total cholesterol levels (243.53±65.74 vs 195.95±29.8 mg/dL; p<0.001) and triglyceride levels (221.07±48.44 vs 180.85±24.74mg/dL; p <0.001) were noted in individuals with raised CIMT compared to individuals with normal CIMT. Majority of the individuals had abnormal HDL (93.00%) and 41.94% of the individuals with abnormal HDL had raised CIMT (p=0.027).
Conclusions: Some individuals with metabolic syndrome are likely to have raised CIMT. The rise in CIMT among the patients with metabolic syndrome is associated with raised SBP, DBP, abnormal HDL (specifically in males), total cholesterol and triglycerides.
References
Gupta R, Sharma KK, Gupta A, Agrawal A, Mohan I, Gupta VP, et al. Persistent high prevalence of cardiovascular risk factors in the urban middle class in India: Jaipur Heart Watch-5. J Assoc Physicians India. 2012 Mar;60(3):11-6.
Hoang KC, Le TV, Wong ND. The metabolic syndrome in East Asians. J Cardiometabolic Syndrome. 2007 Sep;2(4):276-82.
Hwang LC, Bai CH, Chen CJ. Prevalence of obesity and metabolic syndrome in Taiwan. J Formosan Med Association. 2006 Jan 1;105(8):626-35.
Nestel P, Lyu R, Low LP, Sheu WH, Nitiyanant W, Saito I, et al. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pacific J Clin Nutr. 2007 Jun 1;16(2):362-7.
Kolovou GD, Anagnostopoulou KK, Salpea KD, Mikhailidis DP. The prevalence of metabolic syndrome in various populations. Am J Medical Sciences. 2007 Jun 1;333(6):362-71.
Alberti KG, Zimmet P, Shaw J. The metabolic syndrome - a new world-wide definition. Lancet. 2005 Sep 24-30;366(9491):1059-62.
Expert Panel on Detection E. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486.
IDF Worldwide Definition of the Metabolic Syndrome. Diabetes Fed. Available at: https://www.idf.org/e-library/consensus-statements.html. Accessed on 2018 Oct 2.
Després JP, Poirier P, Bergeron J, Tremblay A, Lemieux I, Almeras N. From individual risk factors and the metabolic syndrome to global cardiometabolic risk. Eur Heart J Supplements. 2008 Mar 1;10(suppl_B):B24-33.
Crouse III JR, Tang R, Espeland MA, Terry JG, Morgan T, Mercuri M. Associations of extracranial carotid atherosclerosis progression with coronary status and risk factors in patients with and without coronary artery disease. Circulation. 2002 Oct 15;106(16):2061-6.
Kuller L, Borthani N, Furberg C, Gardin J, Manolio T, O'leary D, et al. Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol. 1994 Jun 15;139(12):1164-79.
Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force endorsed by the Society for Vascular Medicine. J Am Soc Echocardiography. 2008 Feb 1;21(2):93-111.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S13-S27.
O'Leary DH, Bots ML. Imaging of atherosclerosis: Carotid intima-media thickness. Eur Heart J. 2010 Jul;31(14):1682-9.
Koskinen J, Kahonen M, Viikari JS, Taittonen L. Conventional CV risk factors and MetS in predicting carotid intima-media thickness progression in young adults. The CV risk in young Finns study. Circulation. 2009;120:229-36.
Timóteo AT, Carmo MM, Ferreira RC. Can metabolic syndrome presence predict carotid intima-media thickness? J Clin Hypertens (Greenwich). 2012;14(8):507-13.
Zanchetti A, Hennig M, Baurecht H, Tang R, Cuspidi C, Carugo S, et al. Prevalence and incidence of the metabolic syndrome in the European Lacidipine Study on Atherosclerosis (ELSA) and its relation with carotid intima–media thickness. Journal of hypertension. 2007 Dec 1;25(12):2463-70.
Antonini-Canterin F, La Carrubba S, Gullace G, Zito C, Di Bello V, Di Salvo G, et al. Association between carotid atherosclerosis and metabolic syndrome: results from the ISMIR study. Angiology. 2010 Jul;61(5):443-8.
Liu CP, Lin YL, Lin YH, Pao KY, Wu VC, Su TC, et al. The impact of metabolic syndrome, homocysteine, and b vitamins on carotid artery intima-media thickness in hypertensive patients. Acta Cardiol Sin. 2013; 29(1):56-63.
Myung Y, Seo HS, Jung IH, Lee NH, Suh J, Choi JH, et al. The correlation of carotid artery stiffness with heart function in hypertensive patients. J Cardiovasc Ultrasound. 2012 Sep 1;20(3):134-9.
Catena C, Colussi G, Brosolo G, Sechi LA. A prothrombotic state is associated with early arterial damage in hypertensive patients. J Atheroscl Thrombosis. 2012;19(5):471-8.
Sipilä K, Moilanen L, Nieminen T, Reunanen A, Jula A, Salomaa V, et al. Metabolic syndrome and carotid intima media thickness in the Health 2000 Survey. Atherosclerosis. 2009 May 1;204(1):276-81.
