Association between metabolic syndrome and carotid atherosclerosis: a community-based study in Hong Kong
Xin Yi Leng1, Xiang Yan Chen, Ping Chook
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong , Shatin, Hong Kong SAR, China .
Insights
Metabolic syndrome is linked to early carotid atherosclerosis (increased carotid intima media thickness) in Chinese adults, but not advanced stages like plaque or stenosis. This highlights the importance of managing metabolic health to prevent stroke risk.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Medical Imaging
Background:
- Carotid atherosclerosis is a significant risk factor for stroke, even in populations with lower prevalence.
- Metabolic syndrome is a cluster of conditions that increases cardiovascular disease risk.
- Understanding the relationship between metabolic syndrome and carotid atherosclerosis is crucial for stroke prevention strategies in China.
Purpose of the Study:
- To investigate the association between ultrasonographic markers of carotid atherosclerosis and metabolic syndrome in a Chinese community.
- To evaluate if metabolic syndrome is linked to different stages of carotid atherosclerosis, including intima-media thickness, plaque presence, and stenosis.
Main Methods:
- A community-based study involving 653 subjects in Hong Kong.
- Metabolic syndrome defined by presence of ≥3 components: abdominal obesity, high triglycerides, low HDL cholesterol, hypertension, or impaired fasting glucose.
- Carotid duplex ultrasonography used to measure mean carotid intima-media thickness (CIMT), identify carotid plaque (>1.5 mm CIMT), and detect carotid stenosis (≥50% lumen obstruction).
Main Results:
- Metabolic syndrome was present in 28.8% of subjects.
- Increased CIMT was associated with metabolic syndrome (OR 1.17; P=0.014) in multivariate analysis.
- Metabolic syndrome was not significantly associated with the presence of carotid plaque (OR 1.50; P=0.108) or stenosis.
Conclusions:
- Metabolic syndrome is independently associated with increased carotid intima-media thickness, an early marker of atherosclerosis.
- The association between metabolic syndrome and carotid atherosclerosis appears limited to the early stages, not advanced plaque or stenosis.
- Findings suggest that managing metabolic health may be key in preventing the initial development of carotid atherosclerosis and subsequent stroke risk in this population.
Background:
Carotid atherosclerosis should not be neglected as a cause for stroke in China, despite its low prevalence. This study was performed to evaluate the association between ultrasonographic markers for different stages of carotid atherosclerosis and metabolic syndrome.
Methods:
This was a community-based study in Hong Kong. Metabolic syndrome was defined as having three or more of the following conditions or receiving specific treatment for these conditions: Abdominal obesity, elevated triglycerides, low high-density lipoprotein cholesterol, hypertension, and impaired fasting blood glucose. All subjects underwent carotid duplex ultrasonography. Mean carotid intima media thickness (CIMT) of bilateral common carotid arteries was used as the CIMT value for a single subject. CIMT within the 4(th) quartile was regarded as increased CIMT. Carotid plaque was defined as a focal CIMT of >1.5 mm. A carotid plaque obstructing ≥50% of vessel lumen was considered as carotid stenosis.
Results:
A total of 653 subjects (mean age 55.1±10.4; 47.2% male) were recruited. Metabolic syndrome was found in 188 (28.8%) subjects (30.8% in males and 27.0% in females). Mean CIMT was 0.74±0.12 mm. Increased CIMT, carotid plaque, and carotid stenosis were detected in 163 (25.0%), 95 (14.5%), and 6 (1.4%) subjects, respectively. In multivariate linear regression, CIMT significantly increased with increasing numbers of metabolic syndrome components (P<0.001). In multivariate logistic regression analysis, metabolic syndrome was independently associated with increased CIMT [odds ratio (OR) 1.17; 95% confidence interval (CI) 1.11-2.64; P=0.014), but not presence of carotid plaque (OR 1.50; 95% CI 0.92-2.46; P=0.108).
Conclusions:
Metabolic syndrome may be independently associated with the early stage but not the later and advanced stages of carotid atherosclerosis in community residents in China.
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