Abstract 11320: Arterial Stiffness Among Patients With Metabolic Syndrome: Sugar Makes the Difference

Abstract

Introduction. Metabolic syndrome (MS) is associated with adverse cardiovascular events, although its incremental prognostic value, over and beyond the clustering risk factors, has been questioned. Arterial stiffness increases cardiovascular risk in several patient populations and has been associated with MS. Nevertheless, there are no data on the possible differentiation in the level of arterial stiffness among patients with MS according to distinct characteristics and specifically, the glucose status. Methods. We studied 524 never treated hypertensive patients with MS defined by ATP III criteria. Patients with plasma glucose levels above 100 mg/dl were subjected to an oral glucose tolerance test (OGTT). Based on the results of the OGTT test, patients were divided into 4 groups: patients with 1. normal glucose metabolism (N=178), 2. impaired fasting glucose (IFG, N=135), 3. impaired glucose tolerance (IGT, N=132) and 4. diabetes mellitus II (DM II, N=79). Arterial stiffness was assessed by measurement of carotid-femoral pulse wave velocity (PWV), using the Complior device. All patients underwent full biochemical assay, including measurement of high sensitivity C reactive protein (hsCRP). Results. There was a significant increase in PWV values from group 1 to group 4 (8.02±1.47 vs 8.83±1.68 vs 8.94±1.26 vs 10.27±2.09 m/s, respectively) which remained statistically significant even after adjustment for age, gender, smoking, BMI, mean arterial pressure (MAP) and total cholesterol (p<0.001). In multiple regression analysis, applied in the whole cohort, the variables which independently associated with PWV were age, MAP, hsCRP and glucose status (p<0.001 for all). Conclusions. There are significant differences in PWV among patients with MS, partly determined by glucose status. Accordingly, cardiovascular risk may not homogenously spread among these patients, since patients with MS and abnormal glucose metabolism might exhibit higher cardiovascular risk and thus, may prompt earlier intervention.