Abstract 4092: Is There A “Primus Inter Pares” Of ATP-III Metabolic Syndrome Components In Predicting Subclinical Cardiovascular Damage?
Background: Metabolic syndrome (MS; ATP III) is a compound cardiovascular risk factor grouping a number of MS components. We previously showed a continuous relation between the number of MS components and adverse subclinical cardiovascular (CV) disease markers. Limited data is available on the relative causal importance of individual MS components on preclinical CV damage.
Methods: In a representative, randomly sampled cohort of 2524 apparently healthy 35–55 year old subjects (1301 F; median age 46 y), we obtained: basic clinical data, blood samples, echocardiography (GE/Vingmed Vivid7), vascular (carotid, femoral) echography. Measurements single site, observer and device. MS was defined according to the ATP III criteria as 3 or more MS components. Polar plots of odds ratios (OR) of MS components (waist, pressure, low HDL, glycemia, triglycerides), adjusted for age, gender, height, cholesterol, smoking, antihypertensive and lipid lowering drug use were plotted for a number of preclinical CV damage markers.
Results: OR for a number of key sublinical damage phenotypes show very clear heterogeneity. For example in inflammation waist circumference is pre-eminent. For diastolic function, waist and blood pressure predominate. In atherosclerosis low HDL has the largest impact. Furthermore striking differential gender effects are present (see figure⇓)
Conclusions: MS components have very different and heterogeneous effect magnitudes on preclinical CV disease markers: inflammation, cardiac hypertrophy, cardiac & vascular stiffening or atherosclerosis. There is no single ‘primus inter pares’; but different “primi inter pares” for each phenotype under study.