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The Amsterdam Growth and Health Longitudinal Study

Isabel Ferreira, PhD; Ronald M. A. Henry, MD; Jos W. R. Twisk, PhD; Willem van Mechelen, MD, PhD; Han C. G. Kemper, PhD; Coen D. A. Stehouwer, MD, PhD

Arch Intern Med. 2005;165:875-882.

Background  The mechanisms that link the metabolic syndrome to increased cardiovascular risk are incompletely understood, especially in young people. We therefore examined whether the metabolic syndrome was associated with arterial stiffness and whether any such associations were independent of cardiopulmonary fitness and subcutaneous trunk fat.

Methods  Cross-sectional analyses of data on 364 men and women aged 36 years from the Amsterdam Growth and Health Longitudinal Study (ninth follow-up measurement, year 2000). The prevalence of the metabolic syndrome was defined by a slightly modified National Cholesterol Education Program (NCEP) definition. Arterial stiffness was ultrasonically estimated by distensibility and compliance of the carotid, femoral, and brachial arteries and by the carotid elastic modulus.

Results  The prevalence of the metabolic syndrome in this young adult population was 18.3% in men and 3.2% in women. Individuals with the syndrome compared with individuals without risk factors had 11.2% and 17.0% less distensibility and 9.0% and 18.2% less compliance of the carotid and femoral arteries, respectively, and 15.9% higher carotid elastic modulus. After adjustment for cardiopulmonary fitness and subcutaneous trunk fat, the metabolic syndrome remained significantly associated with stiffness of the carotid but not the femoral artery. In addition, poor cardiopulmonary fitness and high subcutaneous trunk fat were associated with arterial stiffness, and this was independent of the metabolic syndrome.

Conclusions  A modified NCEP definition of the metabolic syndrome identified young individuals with increased arterial stiffness. The mechanisms that link the metabolic syndrome, poor cardiopulmonary fitness, and high subcutaneous trunk fat to greater arterial stiffness overlap but are partly independent of each other.

Author Affiliations: Institute for Research in Extramural Medicine (Drs Ferreira, Henry, Twisk, van Mechelen, Kemper, and Stehouwer), Department of Clinical Epidemiology and Biostatistics (Dr Twisk), Department of Social Medicine and Body@Work–Research Centre for Physical Activity, Work, and Health TNO-VU (Dr van Mechelen), and Department of Internal Medicine and Institute for Cardiovascular Research (Drs Henry and Stehouwer),VU University Medical Center, Amsterdam; Department of Public Health, Erasmus University Medical Center, Rotterdam (Dr Ferreira); and Department of Internal Medicine and Cardiovascular Research Institute Maastricht, University Hospital Maastricht, Maastricht (Dr Stehouwer), the Netherlands.

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