Abdominal obesity and subclinical vascular damage in the elderly.
OBJECTIVE
The aim of the present study was to assess the relationships between metabolic syndrome, its components and arterial stiffness as well as evaluate the waist measurement that would accurately identify subclinical vascular damage.


METHODS
Ninety-one participants (16 men) free of cardiovascular diseases with mean age 68.5 +/- 5.1 (range 60-80 years) and a BMI of 27.73 +/- 3.89 were included in the study. In each participant, we evaluated BMI, waist circumference, SBP and DBP, fasting glucose, cholesterol, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides and body composition by dual energy X-ray absorptiometry. Arterial stiffness was assessed by carotid-femoral and carotid-radial pulse wave velocity. We defined subclinical vascular damage as pulse wave velocity higher than 12 m/s. Metabolic syndrome was defined using both International Diabetes Federation (IDF) and National Cholesterol Education Program (NCEP) criteria.


RESULTS
Significant associations were observed between age, triglycerides, waist circumference, trunk fat, SBP and DBP and carotid-femoral pulse wave velocity. Carotid-femoral pulse wave velocity but not carotid-radial pulse wave velocity was significantly higher in patients with metabolic syndrome than in those without metabolic syndrome, independently of its definition (IDF or NCEP). By using waist circumference cut-off suggested by IDF, it was possible to recognize a higher percentage of patients with subclinical vascular damage than by using those suggested by NCEP (88.5 vs. 50%, P = 0.01 and 0.35, respectively).


CONCLUSIONS
These data show that in apparently healthy elderly, metabolic syndrome is strongly associated with subclinical vascular damage. Abdominal obesity and hypertriglyceridemia are also significant predictors of vascular damage. More conservative values of waist cut-off, as suggested by IDF, seem to be able to identify a larger group of patients with subclinical vascular damage, who should be better taken in consideration for treatment.
Fantin
Francesco
F
Department of Biomedical and Surgical Sciences, Section of Geriatrics, University of Verona, Verona, Italy. francesco.fantin@univr.it
Di Francesco
Vincenzo
V
Rossi
Andrea
A
Giuliano
Ketti
K
Marino
Francesca
F
Cazzadori
Marco
M
Gozzoli
Maria P
MP
Vivian
Maria E
ME
Bosello
Ottavio
O
Rajkumar
Chakravarthi
C
Zamboni
Mauro
M
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001808:Blood Vessels / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000150:complications / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D011674:Pulse; D014655:Vascular Resistance; D055105:Waist Circumference