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Open Access Original investigation

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

Ki-Bum Won1, Hyuk-Jae Chang25*, Hyeon-Chang Kim3, Kyewon Jeon4, Hancheol Lee2, Sanghoon Shin2, In-Jeong Cho2, Sung-Ha Park2, Sang-Hak Lee2 and Yangsoo Jang24

Author Affiliations

1 Department of Cardiology, Myongji Cardiovascular Center, Kwandong University College of Medicine, Goyang, Republic of Korea

2 Department of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Republic of Korea

3 Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

4 Severance Biomedical Science Institute, Seoul, Republic of Korea

5 Present address: Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea

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Cardiovascular Diabetology 2013, 12:41  doi:10.1186/1475-2840-12-41

Published: 4 March 2013

Abstract

Background

Metabolic 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.

Methods

Surrogate 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.

Results

The 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).

Conclusions

MS 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.

Keywords:
Metabolic syndrome; Diabetes; Atherosclerosis