Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study
H.J.B.H. Beijers*, R.M. Henry, B. Bravenboer, I. Ferreira, J.M. Dekker, G. Nijpels, C.D.A. Stehouwer
CAPHRI School for Public Health and Primary Care
KIO Kemta
CARIM School for Cardiovascular Diseases
The metabolic syndrome (MetS) is associated with an increased risk of stroke. Arterial remodeling could play an important role herein as maladaptive remodeling is a risk factor for stroke. The purpose of this study was to investigate whether MetS was associated with maladaptive remodeling of the carotid artery and if any such association was independent of hemodynamic variables.
We studied 385 (n = 195 women) nondiabetic, elderly subjects. A MetS z-score (average of sex-specific z-scores of the five MetS traits) was constructed. Intima-media thickness (IMT) and interadventitial diameter (IAD) were assessed by ultrasonography, and lumen diameter (LD), and circumferential wall stress (CWS) were calculated. Multiple linear regression analysis was used to investigate the association between MetS and carotid remodeling.
After adjustment for age, sex, height, prior cardiovascular disease (CVD), dyslipidemia, and smoking, MetS was independently associated with a greater IAD (regression coefficient (beta) per s.d. increase in MetS z-score (95% confidence interval), 0.45 mm (0.28; 0.63)), LD (0.41 mm (0.25; 0.58)) and CWS (5.56 kPa (3.71; 7.42)). These associations were attenuated after additional adjustment for inflammatory, metabolic and particularly hemodynamic variables, but remained statistically significant. No significant association was found between MetS and IMT (0.020 mm (-0.006; 0.046)).
MetS is associated with maladaptive remodeling of the carotid artery, which is the result of changes in LD, IAD, and, to a lesser extent, IMT. This process is independent of hemodynamic variables. Whether this association and process will be observed in a broader population and explains the increased risk of stroke in MetS deserves further study.
American Journal of Hypertension
https://doi.org/10.1038/ajh.2010.256
arterial remodeling
carotid artery
IMPAIRED GLUCOSE-METABOLISM
ARTERIAL STIFFNESS
ISCHEMIC-STROKE
RISK-FACTORS
COMPENSATORY ENLARGEMENT
CARDIOVASCULAR-DISEASE
ADIPOSE-TISSUE
10.1038/ajh.2010.256
Beijers, H. J. B. H., Henry, R. M., Bravenboer, B., Ferreira, I., Dekker, J. M., Nijpels, G., & Stehouwer, C. D. A. (2011). Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study. American Journal of Hypertension, 24(4), 429-436. https://doi.org/10.1038/ajh.2010.256
Beijers, H.J.B.H. ; Henry, R.M. ; Bravenboer, B. et al. / Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study. In: American Journal of Hypertension. 2011 ; Vol. 24, No. 4. pp. 429-436.
@article{aa28219209ab43d5a400d4605d380418,
title = "Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study",
abstract = "BACKGROUNDThe metabolic syndrome (MetS) is associated with an increased risk of stroke. Arterial remodeling could play an important role herein as maladaptive remodeling is a risk factor for stroke. The purpose of this study was to investigate whether MetS was associated with maladaptive remodeling of the carotid artery and if any such association was independent of hemodynamic variables.METHODSWe studied 385 (n = 195 women) nondiabetic, elderly subjects. A MetS z-score (average of sex-specific z-scores of the five MetS traits) was constructed. Intima-media thickness (IMT) and interadventitial diameter (IAD) were assessed by ultrasonography, and lumen diameter (LD), and circumferential wall stress (CWS) were calculated. Multiple linear regression analysis was used to investigate the association between MetS and carotid remodeling.RESULTSAfter adjustment for age, sex, height, prior cardiovascular disease (CVD), dyslipidemia, and smoking, MetS was independently associated with a greater IAD (regression coefficient (beta) per s.d. increase in MetS z-score (95% confidence interval), 0.45 mm (0.28; 0.63)), LD (0.41 mm (0.25; 0.58)) and CWS (5.56 kPa (3.71; 7.42)). These associations were attenuated after additional adjustment for inflammatory, metabolic and particularly hemodynamic variables, but remained statistically significant. No significant association was found between MetS and IMT (0.020 mm (-0.006; 0.046)).CONCLUSIONSMetS is associated with maladaptive remodeling of the carotid artery, which is the result of changes in LD, IAD, and, to a lesser extent, IMT. This process is independent of hemodynamic variables. Whether this association and process will be observed in a broader population and explains the increased risk of stroke in MetS deserves further study.",
keywords = "arterial remodeling, blood pressure, carotid artery, epidemiology, hypertension, metabolic syndrome, stroke, IMPAIRED GLUCOSE-METABOLISM, ARTERIAL STIFFNESS, ISCHEMIC-STROKE, BLOOD-PRESSURE, RISK-FACTORS, COMPENSATORY ENLARGEMENT, CARDIOVASCULAR-DISEASE, INSULIN RESISTANCE, ADIPOSE-TISSUE, PULSE PRESSURE",
author = "H.J.B.H. Beijers and R.M. Henry and B. Bravenboer and I. Ferreira and J.M. Dekker and G. Nijpels and C.D.A. Stehouwer",
doi = "10.1038/ajh.2010.256",
journal = "American Journal of Hypertension",
Beijers, HJBH, Henry, RM, Bravenboer, B, Ferreira, I, Dekker, JM, Nijpels, G & Stehouwer, CDA 2011, 'Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study', American Journal of Hypertension, vol. 24, no. 4, pp. 429-436. https://doi.org/10.1038/ajh.2010.256
Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study. / Beijers, H.J.B.H.; Henry, R.M.; Bravenboer, B. et al.
In: American Journal of Hypertension, Vol. 24, No. 4, 04.2011, p. 429-436.
T1 - Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study
AU - Beijers, H.J.B.H.
AU - Henry, R.M.
AU - Bravenboer, B.
AU - Ferreira, I.
AU - Dekker, J.M.
AU - Nijpels, G.
AU - Stehouwer, C.D.A.
N2 - BACKGROUNDThe metabolic syndrome (MetS) is associated with an increased risk of stroke. Arterial remodeling could play an important role herein as maladaptive remodeling is a risk factor for stroke. The purpose of this study was to investigate whether MetS was associated with maladaptive remodeling of the carotid artery and if any such association was independent of hemodynamic variables.METHODSWe studied 385 (n = 195 women) nondiabetic, elderly subjects. A MetS z-score (average of sex-specific z-scores of the five MetS traits) was constructed. Intima-media thickness (IMT) and interadventitial diameter (IAD) were assessed by ultrasonography, and lumen diameter (LD), and circumferential wall stress (CWS) were calculated. Multiple linear regression analysis was used to investigate the association between MetS and carotid remodeling.RESULTSAfter adjustment for age, sex, height, prior cardiovascular disease (CVD), dyslipidemia, and smoking, MetS was independently associated with a greater IAD (regression coefficient (beta) per s.d. increase in MetS z-score (95% confidence interval), 0.45 mm (0.28; 0.63)), LD (0.41 mm (0.25; 0.58)) and CWS (5.56 kPa (3.71; 7.42)). These associations were attenuated after additional adjustment for inflammatory, metabolic and particularly hemodynamic variables, but remained statistically significant. No significant association was found between MetS and IMT (0.020 mm (-0.006; 0.046)).CONCLUSIONSMetS is associated with maladaptive remodeling of the carotid artery, which is the result of changes in LD, IAD, and, to a lesser extent, IMT. This process is independent of hemodynamic variables. Whether this association and process will be observed in a broader population and explains the increased risk of stroke in MetS deserves further study.
AB - BACKGROUNDThe metabolic syndrome (MetS) is associated with an increased risk of stroke. Arterial remodeling could play an important role herein as maladaptive remodeling is a risk factor for stroke. The purpose of this study was to investigate whether MetS was associated with maladaptive remodeling of the carotid artery and if any such association was independent of hemodynamic variables.METHODSWe studied 385 (n = 195 women) nondiabetic, elderly subjects. A MetS z-score (average of sex-specific z-scores of the five MetS traits) was constructed. Intima-media thickness (IMT) and interadventitial diameter (IAD) were assessed by ultrasonography, and lumen diameter (LD), and circumferential wall stress (CWS) were calculated. Multiple linear regression analysis was used to investigate the association between MetS and carotid remodeling.RESULTSAfter adjustment for age, sex, height, prior cardiovascular disease (CVD), dyslipidemia, and smoking, MetS was independently associated with a greater IAD (regression coefficient (beta) per s.d. increase in MetS z-score (95% confidence interval), 0.45 mm (0.28; 0.63)), LD (0.41 mm (0.25; 0.58)) and CWS (5.56 kPa (3.71; 7.42)). These associations were attenuated after additional adjustment for inflammatory, metabolic and particularly hemodynamic variables, but remained statistically significant. No significant association was found between MetS and IMT (0.020 mm (-0.006; 0.046)).CONCLUSIONSMetS is associated with maladaptive remodeling of the carotid artery, which is the result of changes in LD, IAD, and, to a lesser extent, IMT. This process is independent of hemodynamic variables. Whether this association and process will be observed in a broader population and explains the increased risk of stroke in MetS deserves further study.
KW - arterial remodeling
KW - carotid artery
KW - epidemiology
KW - hypertension
KW - metabolic syndrome
KW - stroke
KW - IMPAIRED GLUCOSE-METABOLISM
KW - ARTERIAL STIFFNESS
KW - ISCHEMIC-STROKE
KW - BLOOD-PRESSURE
KW - RISK-FACTORS
KW - COMPENSATORY ENLARGEMENT
KW - CARDIOVASCULAR-DISEASE
KW - ADIPOSE-TISSUE
KW - PULSE PRESSURE
U2 - 10.1038/ajh.2010.256
DO - 10.1038/ajh.2010.256
JO - American Journal of Hypertension
JF - American Journal of Hypertension
Beijers HJBH, Henry RM, Bravenboer B, Ferreira I, Dekker JM, Nijpels G et al. Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study. American Journal of Hypertension. 2011 Apr;24(4):429-436. doi: 10.1038/ajh.2010.256