Endocrine Abstracts

Background: The presence of the metabolic syndrome (MS) increases cardiovascular morbidity and mortality but few data is available on the outcome in subjects with the MS and subclinical atherosclerosis.

Aim: We aimed to assess cardio- and cerebro-vascular events in subjects with MS and subclinical atherosclerosis.

Methods: We followed-up for 5 years 339 subjects with asymptomatic carotid intima-media thickness >0.9 mm, of whom 130 had the MS, evaluating at baseline traditional cardiovascular risk factors (including male gender, older age, obesity, hypertension, diabetes, smoking, family history of cardiovascular diseases, dyslipidemia) and plasma levels of C-reactive protein and fibrinogen.

Results: Cardio- and cerebro-vascular events were registered in the 29% of subjects with the MS and in the 20% of those without it and the presence of more criteria for the diagnosis of the MS was significantly associated with vascular morbidity and mortality: with transient ischemic attack (P<0.0001), angina (P=0.0022), cardio- and cerebro-vascular death (P=0.0019) and the presence of any clinical event (P=0.0003). Further, we used logistic regression analysis to search for possible independent associations of any parameter evaluated at baseline with the occurrence of clinical events and we found a predictive role for elevated markers of inflammation (OR 3.8, 95% CI 2.6–12.5, P=0.0022), elevated fasting glucose (OR 2.1, 95% CI 1.2–4.0, P=0.0134) and elevated triglycerides (OR 1.4, 95% CI 1.1–2.9, P=0.0351).

Conclusions: These findings confirm a worst vascular outcome in subjects with more criteria for the diagnosis of the MS and further suggest the need of future research to understand the combined role of inflammation and the MS in the progression from subclinical to clinical atherosclerosis.