title: Carotid Plaque Morphology in Asymptomatic Patients with and without Metabolic Syndrome.
abstract: BACKGROUND
  The aim of this study was to determine the impact of metabolic syndrome (MetS) on the morphology of carotid plaques, as evaluated using duplex ultrasound (DUS) with computer-assisted analysis.
  
  
  METHODS
  In this cross-sectional observational study, we analyzed 148 carotid artery plaques in asymptomatic patients. Data were obtained via clinical and laboratory examinations, and DUS was performed by a single operator. All plaques were scanned in a longitudinal fashion, and the best segment was selected, recorded, and evaluated using dedicated software. The main software-based analyses included gray-scale median (GSM) measurements and carotid plaque morphology histograms.
  
  
  RESULTS
  MetS was identified in 51.8% of patients. Comparisons of patients with MetS and patients without MetS indicated that the former patients used more classes of antihypertensive drugs (2.49 vs. 1.93; P = 0.004) and were treated with statins for a longer period (71.08 vs. 49.17 months; P = 0.003). Most patients of both types exhibited moderate carotid artery stenosis ranging from 50% to 69% (n = 62; 37.3%), and MetS was not associated with an increased prevalence of severe carotid artery stenosis. The mean GSM was greater in the MetS group than in the non-MetS group (74.18 vs. 61.63; P = 0.012). The histogram analysis revealed that there were lower quantities of blood and fat (2.91 vs. 3.88; P = 0.006; 10.21 vs. 15.08; P = 0.004, respectively) and more fibrous tissue (19.93 vs. 14.55; P = 0.015) in the carotid plaques of patients with MetS than in the carotid plaques of patients without MetS.
  
  
  CONCLUSIONS
  The present study demonstrated that MetS did not affect the stenosis grade or did it lead to unstable carotid plaques.
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil. Electronic address: mvmcury@hotmail.com.
authors: Marcus Vinícius Martins
authors: MV
authors: Cury
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Calógero
authors: C
authors: Presti
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Suellen Stevam Timotheo
authors: SS
authors: Bonadiman
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Ivan Benaduce
authors: IB
authors: Casella
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Joseph Elias
authors: JE
authors: Benabou
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Erasmo Simão
authors: ES
authors: da Silva
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Nelson
authors: N
authors: de Luccia
authors: Department of Vascular Surgery, Clinics Hospital of the Faculty of Medicine of São Paulo University, São Paulo, SP, Brazil.
authors: Pedro
authors: P
authors: Puech-Leão
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012422:Rupture, Spontaneous; D012720:Severity of Illness Index; D012984:Software; D018616:Ultrasonography, Doppler, Duplex