title: Impact of metabolic syndrome traits on cardiovascular function: should the Adult Treatment Panel III definition be further stratified?
abstract: OBJECTIVE
  The aims of the study were to evaluate whether a further classification of metabolic syndrome according to the number of traits (based on the Adult Treatment Panel III definition) could better explain the impact on cardiovascular remodeling and function, and to assess the role of single metabolic syndrome components in this regard.
  
  
  METHODS
  We studied by echocardiography and carotid ultrasound 435 asymptomatic patients with metabolic syndrome. Patients with coronary artery disease or more than mild valvular heart disease were excluded. Carotid stiffness index (β) was measured using a high-resolution echo-tracking system. Patients with metabolic syndrome were divided into two groups: metabolic syndrome with three traits (Gr.1) and metabolic syndrome with four or five traits (Gr. 2).
  
  
  RESULTS
  Patients in Gr. 2 had higher left ventricular mass index (P < 0.001), left ventricular end-diastolic volume index (P = 0.029), left atrial volume index (P = 0.002), E/e' ratio (P = 0.002), intima-media thickness (P = 0.031), and prevalence of plaques (P = 0.01) than patients in Gr. 1. Left ventricular ejection fraction was similar in both groups. The mean carotid β index tended to be higher in Gr. 2. Considering metabolic syndrome traits separately, in an age-corrected multivariate analysis, abdominal obesity was found to have the strongest association with cardiac structure and carotid artery atherosclerosis and stiffness.
  
  
  CONCLUSIONS
  An increasing number of metabolic syndrome traits had a significantly worse impact on cardiac remodeling and function and carotid artery atherosclerosis. Abdominal obesity showed the strongest association with cardiac structure, carotid artery stiffness, and intima-media thickness. Prospective studies are needed to evaluate whether a new classification of metabolic syndrome using the number of traits could add prognostic information.
authors: aCardiologia Preventiva e Riabilitativa, ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone bCardiologia, Ospedale S. Antonio, San Daniele del Friuli cMedicina Interna, Ospedale Villa Sofia, Palermo dCardiologia, Università di Pisa, Pisa eCardiologia, Università di Messina, Messina, Italy f'Carol Davila' University of Medicine and Pharmacy, 'Prof. Dr C.C. Iliescu' Institute of Cardiovascular Diseases, Bucharest, Romania gCardiologia, ARC, Azienda Ospedaliera S. Maria degli Angeli, Pordenone, Italy.
authors: Francesco
authors: F
authors: Antonini-Canterin
authors: Anca D
authors: AD
authors: Mateescu
authors: Olga
authors: O
authors: Vriz
authors: Salvatore
authors: S
authors: La Carrubba
authors: Vitantonio
authors: V
authors: Di Bello
authors: Scipione
authors: S
authors: Carerj
authors: Concetta
authors: C
authors: Zito
authors: Lina
authors: L
authors: Sparacino
authors: Cătălin
authors: C
authors: Uşurelu
authors: Răzvan
authors: R
authors: Ticulescu
authors: Carmen
authors: C
authors: Ginghină
authors: Gian L
authors: GL
authors: Nicolosi
authors: Bogdan A
authors: BA
authors: Popescu
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications* / Q000453:epidemiology; D020212:Carotid Artery Injuries / Q000453:epidemiology; D016893:Carotid Stenosis / Q000453:epidemiology; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000145:classification* / Q000150:complications* / Q000000981:diagnostic imaging; D008875:Middle Aged; D014463:Ultrasonography; D020257:Ventricular Remodeling / Q000502:physiology