title: Association between metabolic syndrome or its components and asymptomatic cardiovascular disease in the RIVANA-study.
abstract: OBJECTIVE
  To assess the association between the metabolic syndrome (MetSd) and asymptomatic cardiovascular disease and determine if the MetSd or its single risk factors perform better in discriminating prevalent asymptomatic cardiovascular disease.
  
  
  METHODS
  A total of 880 community-dwelling subjects (423 with and 457 without MetSd according to ATPIII) underwent a physical examination, an echocardiography and an ultrasound examination of carotid arteries and blood and urine samples were collected. Associations between the subclinical organ damage markers and the MetSd were addressed with non-conditional logistic regression. AUCs of ROCs were used to compare the models' ability to discriminate asymptomatic cardiovascular disease.
  
  
  RESULTS
  The MetSd was independently associated with carotid subclinical atherosclerosis, increased left ventricular mass index and cardiac dysfunction. The MetSd did not discriminate prevalent increased carotid intima-media thickness better than abdominal obesity and impaired fasting glucose [AUC=0.75 (95% CI: 0.71-0.78) and 0.75 (0.71-0.79), respectively; p=0.55]. The MetSd performed worse than abdominal obesity in discriminating increased left ventricular mass index among males younger than 65 years [AUC=0.66 (95% CI: 0.62-0.69) and 0.69 (0.66-0.73), respectively; p=0.02]. No differences between the ability of MetSd or its components in discriminating increased left ventricular mass index were observed among older men or women. The discrimination ability for microalbuminuria for the MetSd or impaired fasting glucose was not statistically different [AUC=0.67 (95% CI: 0.60-0.74) and 0.69 (0.62-0.76), respectively; p=0.18].
  
  
  CONCLUSIONS
  This study supports the association between the MetSd and asymptomatic cardiovascular disease. The construct of the MetSd might not be better than its single components in addressing cardiovascular risk.
authors.affiliation: Department of Health Education and Development, Department of Health, Government of Navarra, Pamplona (Navarra), Spain. mguembes@cfnavarra.es
authors.forename: M J
authors.initials: MJ
authors.lastname: Guembe
authors.forename: E
authors.initials: E
authors.lastname: Toledo
authors.forename: J
authors.initials: J
authors.lastname: Barba
authors.forename: E
authors.initials: E
authors.lastname: Martínez-Vila
authors.forename: P
authors.initials: P
authors.lastname: González-Diego
authors.forename: P
authors.initials: P
authors.lastname: Irimia
authors.forename: J
authors.initials: J
authors.lastname: Díez
authors.forename: J J
authors.initials: JJ
authors.lastname: Viñes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis*; D002339:Carotid Arteries / Q000473:pathology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011897:Random Allocation; D012044:Regression Analysis; D012307:Risk Factors; D014463:Ultrasonography / Q000379:methods