title: Differential impact of metabolic syndrome on subclinical atherosclerosis according to the presence of diabetes.
abstract: BACKGROUND
  Metabolic syndrome (MS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. However, data on the impact of MS and its individual components on subclinical atherosclerosis (SCA) according to diabetes status are scarce.
  
  
  METHODS
  Surrogate markers of SCA, brachial-ankle pulse wave velocity (baPWV), and carotid intima-medial thickness (IMT) and plaque were assessed in 2,560 subjects (60 ± 8 years, 33% men) who participated in baseline health examinations for a community-based cohort study.
  
  
  RESULTS
  The participants included 2,149 non-diabetics (84%) and 411 diabetics (16%); 667 non-diabetics (31%) and 285 diabetics (69%) had MS, respectively. Diabetics had significantly higher baPWV and carotid IMT, and more plaques than non-diabetics (p < 0.001, respectively). Individuals with MS had significantly higher baPWV and carotid IMT than those without MS only among non-diabetics (p < 0.001, respectively). Among MS components, increased blood pressure was significantly associated with the exacerbation of all SCA markers in non-diabetics. The number of MS components was significantly correlated with both baPWV and carotid IMT in non-diabetics (baPWV: r = 0.302, p < 0.001; carotid IMT: r = 0.217, p < 0.001). Multiple regression showed both MS and diabetes were significantly associated with baPWV (p < 0.001, respectively), carotid IMT (MS: p < 0.001; diabetes: p = 0.005), and the presence of plaque (MS: p = 0.041; diabetes: p = 0.002).
  
  
  CONCLUSIONS
  MS has an incremental impact on SCA in conditions without diabetes. The identification of MS and its individual components is more important for the risk stratification of CVD in non-diabetic individuals.
authors: Department of Cardiology, Myongji Cardiovascular Center, Kwandong University College of Medicine, Goyang, Republic of Korea.
authors: Ki-Bum
authors: KB
authors: Won
authors: Hyuk-Jae
authors: HJ
authors: Chang
authors: Hyeon-Chang
authors: HC
authors: Kim
authors: Kyewon
authors: K
authors: Jeon
authors: Hancheol
authors: H
authors: Lee
authors: Sanghoon
authors: S
authors: Shin
authors: In-Jeong
authors: IJ
authors: Cho
authors: Sung-Ha
authors: SH
authors: Park
authors: Sang-Hak
authors: SH
authors: Lee
authors: Yangsoo
authors: Y
authors: Jang
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D011446:Prospective Studies