The Risk of the Metabolic Syndrome on Carotid Thickness and Stiffness: Sex and Age Specific Effects

Background And Purpose: The metabolic syndrome (MS) is associated with a high risk for cardiovascular disease. Intima-media thickness (IMT) and stiffness reflect structure and functional alterations in arteries. We investigated the relationship of MS on IMT and stiffness and also dissected its gender and age specific effect.

Methods: Carotid segment-specific IMT and stiffness were obtained in 1245 stroke- and myocardial infarction free volunteers between the ages of 15 and 87. The MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III with Asian modification.

Results: The prevalence of MS was 22.2% in our study population. The MS was associated with increased IMT in the common carotid artery (CCA IMT) and stiffness modalities (including Ep, beta, and PWV), but was not associated with bifurcation and internal carotid artery IMT. The relationship of MS on atherosclerosis was more prominent in women than in men. Only women revealed a significant interaction between MS and age for CCA IMT (p=0.013), which was more pronounced in young women (< or = 45 years) than in elderly. Comparing the risk components between young and elderly women in regard to MS, high triglycerides were more common in the affected young women (p=0.007).

Conclusions: MS is associated with a risk for increased CCA IMT and stiffness, and this relationship is particularly pronounced in women. Age can modify the MS impact on atherosclerosis. Young women with MS who often have high triglycerides experience the highest risk to associate with atherosclerosis. Young MS women who are easily overlooked for atherosclerotic diseases need more detailed assessment for atherosclerosis to prevent premature cardiovascular disease.