title: Inverse association between central obesity and arterial stiffness in Korean subjects with metabolic syndrome: a cross-sectional cohort study.
abstract: BACKGROUND
  Metabolic syndrome (MetS) is associated with increased risks of diabetes and atherosclerotic cardiovascular disease. Whether central obesity (CeO) is a prerequisite for the diagnosis of MetS in the International Diabetes Federation (IDF) definition is a substantial issue because it may influence the clinical value of MetS for predicting subclinical atherosclerosis.
  
  
  METHODS
  We investigated the relation between MetS, as defined by the National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III criteria, and arterial stiffness according to CeO status in 2,560 healthy Korean subjects who participated in a community-based cohort study. Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV).
  
  
  RESULTS
  The prevalence of MetS was 37%; 84% of MetS subjects had CeO. The prevalence of diabetes was significantly higher in MetS subjects than in non-MetS subjects (30 vs. 8%, p <0.001). The number of MetS components was significantly correlated with baPWV (r = 0.311, p <0.001). In a subgroup analysis of MetS subjects, the prevalence of diabetes was not significantly different in MetS subjects with and without CeO. MetS subjects without CeO had significantly higher baPWV than those with CeO (1654 ± 315 vs. 1578 ± 270 cm/s, p = 0.002). Multiple regression models revealed that waist circumference was independently associated with decreased baPWV in MetS subjects.
  
  
  CONCLUSIONS
  Despite the significant correlation between the number of MetS components and arterial stiffness, there appeared to be an inverse association between CeO and arterial stiffness in MetS subjects. In contrast to the IDF definition, our findings suggest that CeO is not crucial for the diagnosis of MetS in otherwise healthy Koreans having multiple metabolic risk factors with respect to subclinical atherosclerosis reflected in arterial stiffness.
authors: Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea ; Division of Cardiology, St. Luke's International Hospital, Tokyo, Japan.
authors: Ki-Bum
authors: KB
authors: Won
authors: Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea ; Severance Biomedical Science Institute, Seoul, Republic of Korea.
authors: Hyuk-Jae
authors: HJ
authors: Chang
authors: Division of Cardiology, St. Luke's International Hospital, Tokyo, Japan.
authors: Hiroyuki
authors: H
authors: Niinuma
authors: Division of Cardiology, St. Luke's International Hospital, Tokyo, Japan.
authors: Koichiro
authors: K
authors: Niwa
authors: Severance Biomedical Science Institute, Seoul, Republic of Korea.
authors: Kyewon
authors: K
authors: Jeon
authors: Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea.
authors: In-Jeong
authors: IJ
authors: Cho
authors: Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea.
authors: Chi-Young
authors: CY
authors: Shim
authors: Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea.
authors: Geu-Ru
authors: GR
authors: Hong
authors: Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemungu, Seoul, 120-752 Republic of Korea.
authors: Namsik
authors: N
authors: Chung
keywords: Central obesity; Metabolic syndrome; Pulse wave velocity