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11-03-2010 | Cardiometabolic | Article

Metabolic syndrome associated with subclinical CVD

Abstract

Free abstract

MedWire News: People with the metabolic syndrome (MS) are at increased risk for asymptomatic cardiovascular disease (CVD), a community-based study has found.

But the significance of this finding is debatable, say the study authors, who also found that the MS, as a construct, was no better than its component parts in predicting cardiovascular risk.

“Therefore, from a clinical and a public health perspective, the importance of preventing abdominal obesity and impaired fasting glucose in [an] asymptomatic population is highlighted,” say María Jesús Guembe (Recinto Hospital de Navarra, Pamplona, Spain) and fellow researchers in the journal Atherosclerosis.

The study involved 880 apparently healthy community-dwelling individuals who underwent physical examination, echocardiography, and carotid artery ultrasound. They were taking part in the Risk of Vascular Disease in Navarra (RIVANA) study.

Under the Adult Treatment Panel III definition, 423 participants met the criteria for the MS. These individuals were significantly more likely than others to have subclinical atherosclerosis (as indicated by an increased carotid intima-media thickness), increased left ventricular mass index, and cardiac dysfunction.

Analysis of receiver operating characteristic curves suggested that the MS was equivalent to the combined presence of abdominal obesity and impaired fasting glucose for predicting subclinical atherosclerosis; both measures had area under the curve scores (AUC) of 0.75.

Similarly, the MS was equivalent to its component parts for predicting left ventricular hypertrophy in older men and women, and was actually inferior among men aged 65 years and under, with AUCs of 0.66 and 0.69, respectively.

This is the first time that age has been found to modulate the interaction between the MS (or its components) and increased left ventricular mass, the authors remark.

Finally, the MS was equivalent to impaired fasting glucose for predicting microalbuminuria, with AUCs of 0.67 and 0.69, respectively.

Guembe and co-authors call for the interaction between age, MS, and left ventricular mass to be confirmed in further studies.

They conclude: “This study provides new evidence for the independent association between the MS and asymptomatic CVD… In these associations, the construct of the MS is not better or might be not as good as its individual components for identifying subjects with asymptomatic CVD burden.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Joanna Lyford