title: Indicators of Cardiovascular Risk in Metabolic Syndrome: Long Term Follow-up in Italian Patients.
abstract: BACKGROUND
  Cardiovascular risk (CV) factors associated with the metabolic syndrome (MetS) may vary in different populations. In some, hypertension may be the major determinant, in others are low high-density lipoprotein cholesterol (HDL-C), high triglycerides, or another component.
  
  
  METHODS
  Subjects included in this analysis were identified in 2006, among those attending the Lipid Clinic of the Niguarda Hospital, and followed up through to 2013. Patient characteristics (including the occurrence of CV events) were obtained from electronic medical records. MetS was diagnosed according to the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) guidelines. The carotid intima media thickness (cIMT) was also followed in these patients over the years.
  
  
  RESULTS
  After 7 years a total of 858 subjects had a complete follow-up; 271 of those had MetS. Patients developing a CV event showed elevated baseline cIMT (e.g. cIMTmax ≥ 2.4 mm in males and ≥ 2.2 mm in females); moreover the cIMT in MetS patients was higher at baseline and the rise over 7 years was larger compared with patients without MetS. By examining each body variable for MetS we found that a waist to height ratio (WHtR) ≥ 0.5 was present in nearly all subjects with a CV event.
  
  
  CONCLUSIONS
  The follow-up data of a series of Italian patients with and without MetS, clearly indicates that the former have a raised cIMT and their arterial IMT progression is greater and the presence of a larger WHtR is apparently linked to a higher incidence of CV events.
authors.affiliation: Centro Dislipidemie, Dip. Cardiotoracovascolare, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Mombelli
authors.affiliation: Centro Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pavanello
authors.affiliation: Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: Samuela
authors.initials: S
authors.lastname: Castelnuovo
authors.affiliation: Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Bosisio
authors.affiliation: Centro Grossi Paoletti, Dipartimento di Scienze Farmacologiche e Biomolecolari, Università degli Studi di Milano, Milano, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Simonelli
authors.affiliation: Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Pazzucconi
authors.affiliation: Centro Dislipidemie, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
authors.forename: Cesare Riccardo
authors.initials: CR
authors.lastname: Sirtori
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
keywords: Metabolic syndrome; cardiovascular
  risk; carotid intima media thickness; waist circumference; waist-to-height ratio