Intra-renal hemodynamics and carotid intima-media thickness in the metabolic syndrome.
OBJECTIVE
Metabolic syndrome (MetS) is associated with increased cardiovascular risk. We hypothesize that early vascular changes are already present at the time of diagnosis of MetS. The relationship of different measures of early vascular impairment with body fat distribution and the natural progression of MetS was examined in newly diagnosed subjects non-pharmacologically treated.


METHODS
246 consecutively enrolled subjects were categorized according to the presence of MetS and type 2 diabetes (T2D). Intra-renal Doppler flow was used to ascertain resistive (RI) and pulsatility (PI) indices as markers of vascular resistance. Carotid intima-media thickness (IMT), cutis-rectis (CR) and rectis-aorta (RA) thicknesses were measured by ultrasonography; RA/CR ratio was used as measure of body fat distribution. Pro-inflammatory cytokines, C-reactive protein, oxidative markers insulin and adiponectin blood concentrations were also measured.


RESULTS
Baseline characteristics demonstrated increasing trends in biochemical, inflammatory, and oxidative parameters from MetS-, MetS+, to MetS+/T2D (p<0.001). After adjusting for age, the same increasing trends across the groups were observed in both sexes in IMT (p<0.001), RI (p<0.001) and PI (p<0.001). IMT correlated with RI (r=0.25; p<0.001), PI (r=0.26; p<0.001), and RA/CR ratio (r=0.43; p<0.001).


CONCLUSIONS
Carotid IMT and intra-renal resistances are elevated at an early stage in MetS and are associated with a dysregulated production of fat-derived hormones and cytokines.
Buscemi
Silvio
S
Department of Internal Medicine, Cardiovascular and Kidney Diseases, University of Palermo, Palermo, Italy. silbus@tin.it
Verga
Salvatore
S
Batsis
John A
JA
Cottone
Santina
S
Mattina
Alessandro
A
Re
Andrea
A
Arnone
Mariangela
M
Citarda
Salvatore
S
Cerasola
Giovanni
G
D000273:Adipose Tissue / Q000033:anatomy & histology; D000328:Adult; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D002339:Carotid Arteries / Q000473:pathology*; D017097:Electric Impedance; D005260:Female; D005919:Glomerular Filtration Rate; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D008875:Middle Aged; D009765:Obesity / Q000473:pathology / Q000503:physiopathology; D050177:Overweight / Q000473:pathology / Q000503:physiopathology; D012079:Renal Circulation / Q000502:physiology*; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D014463:Ultrasonography
D008055:Lipids