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Metabolic Syndrome and the Progression of Carotid Intima-Media Thickness in Elderly Women
Maija Hassinen, MSc;
Pirjo Komulainen, MSc;
Timo A. Lakka, MD, PhD;
Sari B. Väisänen, PhD;
Irja Haapala, PhD;
Helena Gylling, MD, PhD;
Markku Alen, MD, PhD;
Arno Schmidt-Trucksäss, MD, PhD;
Aulikki Nissinen, MD, PhD;
Rainer Rauramaa, MD, PhD
Arch Intern Med. 2006;166:444-449.
Background: Although the metabolic syndrome can predict cardiovascular events in middle-aged individuals, data on its association with the progression of subclinical atherosclerosis, particularly in elderly women, are limited. We investigated the association of the metabolic syndrome with the progression of carotid intima-media thickness (IMT) in elderly women.
Methods: We performed a 12-year follow-up study in a population-based sample of 101 women (age range at baseline, 60-70 years). All study variables were measured at baseline and 12 years later. We used the National Cholesterol Education Program definition for metabolic syndrome ( 3 of 5 risk factors) and quantified carotid IMT noninvasively by ultrasonography.
Results: The prevalence of metabolic syndrome increased from 13% at baseline to 46% after 12 years of follow-up (P<.001). The mean ± SD IMT increased by 21% (from 1.05 ± 0.31 mm to 1.27 ± 0.38 mm) during 12 years (P<.001). Among the individuals without metabolic syndrome at baseline, the increase in carotid IMT was greater in 34 women who developed metabolic syndrome during 12 years (0.31 ± 0.37 mm) than in 54 women who did not (0.16 ± 0.25 mm) after adjustment for age, prevalent cardiovascular diseases, physical activity, smoking, alcohol intake, serum low-density lipoprotein cholesterol level, use of cholesterol-lowering medication, carotid IMT, and National Cholesterol Education Program metabolic risk score at baseline (P = .04 for difference).
Conclusion: Incident metabolic syndrome is associated with accelerated progression of carotid IMT in elderly women.
Author Affiliations: Kuopio Research Institute of Exercise Medicine, Kuopio, Finland (Mss Hassinen and Komulainen and Drs Lakka, Väisänen, Alen, and Rauramaa); Department of Nutrition and Dietetics, King’s College London, London, England (Dr Haapala); Departments of Physiology (Dr Lakka) and Clinical Nutrition (Dr Gylling), University of Kuopio, Kuopio; Department of Rehabilitative and Preventative Sports Medicine, Technical University of Munich, Munich, Germany (Dr Schmidt-Trucksäss); Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland (Dr Nissinen); and Laboratory Centre (Dr Väisänen) and Department of Clinical Physiology and Nuclear Medicine (Dr Rauramaa), Kuopio University Hospital, Kuopio.
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