title: Metabolic syndrome and vascular alterations in normotensive subjects at risk of diabetes mellitus.
abstract: We evaluated the possible association between early vascular abnormalities and the metabolic syndrome (MS) in 77 normotensive subjects (mean age: 50 years) at risk of developing diabetes for family history of diabetes, obesity, or impaired fasting glucose. Fifty healthy subjects were recruited as controls. MS was defined according to the ATP III criteria. Brachial artery endothelium-dependent and -independent vasodilation were assessed as flow-mediated dilation (FMD) and response to glyceryl trinitrate (GTN, 25 microg sublingual), respectively, by automatic computerized edge detection system. Carotid-femoral pulse wave velocity (PWV) and radial augmentation index (AIx) were assessed by applanation tonometry. PWV was significantly (P<0.01) higher in subjects with MS (n=29, 9.0+/-1.9 m/s) as compared with those without MS (n=48, 7.7+/-1.2 m/s) and controls (7.2+/-1.5 m/s). FMD was significantly (P<0.05) reduced in both subjects with (5.8+/-2.7%) and without MS (6.1+/-3.7%) as compared with controls (6.9+/-2.5%). No significant differences were found for response to GTN and AIx. PWV and FMD were significantly (P<0.05) affected by increasing number of MS components. Among the components of the MS, only blood pressure significantly affected PWV, whereas blood pressure and fasting glucose influenced FMD. Logistic regression analysis showed that MS was associated with increased risk of altered PVW (odd ratio: 7.95, confidence limits: 1.06 to 69.11), whereas only blood pressure component was significantly related with increased risk of impaired FMD (odd ratio: 3.60, confidence limits: 1.01 to 12.78). In conclusion, in normotensive subjects at risk of developing diabetes mellitus, the presence of MS is associated with a selective alteration of central PWV.
authors.affiliation: Department of Internal Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy. l.ghiadoni@med.unipi.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ghiadoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Penno
authors.forename: Chiara
authors.initials: C
authors.lastname: Giannarelli
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Plantinga
authors.forename: Melania
authors.initials: M
authors.lastname: Bernardini
authors.forename: Laura
authors.initials: L
authors.lastname: Pucci
authors.forename: Roberto
authors.initials: R
authors.lastname: Miccoli
authors.forename: Stefano
authors.initials: S
authors.lastname: Taddei
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvetti
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
mesh_terms: D000328:Adult; D001158:Arteries / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000209:etiology*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000503:physiopathology*; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D011674:Pulse; D017534:Radial Artery / Q000503:physiopathology; D012039:Regional Blood Flow; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin