title: Metabolic syndrome and subclinical carotid atherosclerosis among Chinese elderly people living in a rural community.
abstract: BACKGROUND
  The relationship between the metabolic syndrome and subclinical atherosclerosis among elderly people remains controversial. We seek to investigate the associations of metabolic syndrome and its components with subclinical carotid atherosclerosis in older people living in rural China.
  
  
  METHODS
  This cross-sectional study included 911 participants (age ≥60 years, 59.4% women) of the community-based Confucius Hometown Aging Project in Shandong, China, who were free of clinical cardiovascular disease. In 2010-2011, data were collected through interviews, clinical examinations, and laboratory tests. Carotid intima media thickness (cIMT) and carotid artery plaque were assessed using ultrasonography. Metabolic syndrome was defined by four sets of criteria. Data were analyzed with multiple general linear and logistic regression models.
  
  
  RESULTS
  Carotid plaque was detected in 514 (56.4%) persons. Depending on the defining criteria, prevalence of metabolic syndrome ranged from 30.6% to 56.9%. Hypertension, elevated blood pressure (≥130/85 mmHg), diabetes/prediabetes, and high fasting plasma glucose (≥5.6 mmol/L) were significantly associated with an increased likelihood of carotid plaque, whereas an increased cIMT was associated with elevated blood pressure and hypertension (P<0.05). Obesity, high triglycerides, and dyslipidemia were not associated with carotid artery plaque or cIMT. The significant association of metabolic syndrome with an increased likelihood of carotid plaque disappeared when elevated blood pressure and high plasma glucose were added to the models. Metabolic syndrome was not associated with cIMT.
  
  
  CONCLUSIONS
  Metabolic syndrome is associated with subclinical carotid plaque among Chinese elderly people, driven primarily by elevated blood pressure and hyperglycemia. Older adults with metabolic syndrome, especially those with high blood pressure and hyperglycemia, may benefit from evaluation for subclinical atherosclerosis.
authors.affiliation: 1 Department of Neurology, Jining First People's Hospital , Shandong, China .
authors.forename: Zhongrui
authors.initials: Z
authors.lastname: Yan
authors.forename: Yajun
authors.initials: Y
authors.lastname: Liang
authors.forename: Hui
authors.initials: H
authors.lastname: Jiang
authors.forename: Chuanzhu
authors.initials: C
authors.lastname: Cai
authors.forename: Binglun
authors.initials: B
authors.lastname: Sun
authors.forename: Chengxuan
authors.initials: C
authors.lastname: Qiu
mesh_terms: D000368:Aged; D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D002340:Carotid Artery Diseases / Q000150:complications* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology*; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose