Abstract 821: Metabolic Syndrome, Diabetes, Inflammation, and Progression of Carotid Atherosclerosis
Background: Metabolic syndrome (MetS) and diabetes mellitus (DM) are inflammatory conditions associated with an increased risk of cardiovascular disease (CVD). We examined the association of MetS and DM with progression of atherosclerosis using carotid intimal medial thickness (CIMT) and tested if inflammation was associated with further progression of CIMT.
Methods: We studied 3197 older adults (62% female, 4% African-American), participants of the Cardiovascular Health Study, a longitudinal study of CVD in adults aged ≥65 without CVD at baseline, who had both baseline and follow-up CIMT measures averaging 2.9±0.1 years apart. MetS was defined by AHA/NHLBI criteria and DM by fasting glucose ≥126 mg/dl or use of medications. The annualized change in combined CIMT was defined as the standardized averages of maximal common and internal CIMT between baseline and follow-up scans divided by the time between scans in years. The presence of inflammation was determined as either a C-reactive protein >3 mg/L or being in the highest quartile for interleukin-6 and/or lipoprotein-associated phospholipase A2. Analysis of covariance, adjusted for non-MetS risk factors, was used to compare change in CIMT by disease group stratified by presence of inflammation.
Results: 1010 persons (32%) had MetS and 358 persons (11%) had DM at baseline. Following adjustment for age, gender, race, smoking, and total cholesterol, DM was associated with greater progression of CIMT than those with neither MetS nor DM (p<0.05); those with MetS had greater progression of CIMT when inflammation was present (Table⇓). The impact of inflammation across disease groups, however, did not differ (p-interaction=0.79).
Conclusions: In older adults, DM is associated with the greater increases in CIMT; inflammation may also contribute to CIMT progression in those with MetS. Further investigation is needed to determine if these findings translate into increased CVD event rates.