Significance of arterial stiffness and relationship with other noninvasive methods for the assessment of subclinical atherosclerosis inpatients with metabolic syndrome

Abstract

Measurement of arterial stiffness is an accurate method of assessment of endothelial dysfunction, together with other noninvasive methods, in the diagnosis of atherosclerotic burden in patients with MetS.

Material and methods: The study included 63 patients: MetS group (18 men, 20 women, mean age 58.86 +/- 8.86 years) and the control group (14 men, 11 women, mean age 59.68 +/- 10.0 years). They underwent the following examinations: assessment of arterial stiffness--pulse wave velocity (PWVao), augmentation index of brachial artery (Aixbr) and aorta (Aixao), central systolic blood pressure (SBPao); carotid ultrasound for detection of plaques and measurement of intima-media thickness (IMT); echocardiography--left ventricular hypertrophy (LVH); ankle-brachial index (ABI); biochemical parameters: C-reactive protein (CRP), fibrinogen (Fb), cholesterol (Col), HDLcol, LDLcol and triglycerides.

Results: MetS patients had higher PWVao (10.06 +/- 2.12 m/s vs 8.29 +/- 1.33 m/s, p = 0.0001) and SBPao (135.06 +/- 19.80 mmHg vs. 121.76 +/- 18.62 mmHg, p = 0.009). Carotid IMT was higher in MetS group (0.92 +/- 0.11 vs. 0.83 +/- 0.10 mm, p = 0.003). Almost all MetS patients were hypertensive (94.7% vs. 52%, p = 0.01); LVH was present in 57.9% of MetS patients and 20% of the controls (p = 0.05). The MetS group presented higher Col (208.76 +/- 38.41 vs. 176.20 +/- 30.08 mg/dl, p = 0.0003) and CRP levels (0.872 +/- 0.852 mg/dl vs. 0.476 +/- 0.392 mg/dl, p = 0.01).

Conclusions: In MetS patients the most reliable marker of arterial stiffness was PWVao, followed by SBPao. Higher values of carotid IMT are also parameters of high atherosclerotic risk. CRP and Col can be considered biomarkers of high risk in MetS.