title: Increased subclinical atherosclerosis in young adults with metabolic syndrome: the Bogalusa Heart Study.
abstract: OBJECTIVE
  The purpose of this study was to investigate the association of metabolic syndrome (MetS) with subclinical atherosclerosis, determined by ultrasound carotid intima-media thickness (CIMT) measurements, in young adults.
  
  
  BACKGROUND
  Metabolic syndrome is associated with subclinical atherosclerosis and increased cardiovascular risk in older and middle-aged adults; however, these associations have not been studied among young adults.
  
  
  METHODS
  Non-diabetic subjects from Bogalusa Heart Study, a longitudinal study of atherosclerosis in young adults, underwent B-mode ultrasonography of the carotid arteries. Metabolic syndrome was defined with the National Cholesterol Education Program Adult Treatment Panel III (MetSNCEP) and World Health Organization (MetSWHO) definitions. CIMT and MetS associations were evaluated with multivariable regression and area under receiver-operator characteristic curve (AUC) analyses.
  
  
  RESULTS
  Of 507 subjects (29% black, 39% male, mean [SD] age 32 [3] years), 67 (13%) had MetSNCEP and 65 (13%) had MetSWHO. Common (mean = 0.70 [0.11] mm vs. 0.66 [0.08] mm, p = 0.002) and internal CIMT (0.72 [0.21] mm vs. 0.68 [0.12] mm, p = 0.020) were higher among those with MetS(NCEP) than those without MetS(NCEP). Common (0.69 [0.11] mm vs. 0.66 [0.08] mm, p = 0.020) and internal CIMT (0.73 [0.23] mm vs. 0.68 [0.12] mm, p = 0.012) also were higher among those with MetSWHO than those without MetSWHO. Composite CIMT increased with the number of MetS components present (MetSNCEP r = 0.997, p < 0.001; MetSWHO r = 0.946, p = 0.053). Metabolic syndromeNCEP (AUC = 0.557, 95% confidence interval [CI] 0.513 to 0.601) and MetSWHO (AUC = 0.539, 95% CI 0.495 to 0.584) both predicted composite CIMT > or =75th percentile.
  
  
  CONCLUSIONS
  In young adults, MetS is associated with increased atherosclerotic burden, and therefore, increased cardiovascular risk. These results support the importance of screening and early intervention in this population.
authors.affiliation: Atherosclerosis Imaging Research Program, Section of Cardiovascular Medicine, University Medical School, Madison, Wisconsin 53792, USA.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Tzou
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Douglas
authors.forename: Sathanur R
authors.initials: SR
authors.lastname: Srinivasan
authors.forename: M Gene
authors.initials: MG
authors.lastname: Bond
authors.forename: Rong
authors.initials: R
authors.lastname: Tang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Berenson
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D000328:Adult; D017677:Age Distribution; D001161:Arteriosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D016017:Odds Ratio; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D018608:Ultrasonography, Doppler; D049629:Waist-Hip Ratio