Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study

Beijers, Hanneke J. B. H., Henry, Ronald M. A., Bravenboer, Bert, Ferreira, Isabel, Dekker, Jacqueline M., Nijpels, Giel and Stehouwer, Coen D. A. (2011) Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study. American Journal of Hypertension, 24 4: 429-436. doi:10.1038/ajh.2010.256

Author Beijers, Hanneke J. B. H.
Henry, Ronald M. A.
Bravenboer, Bert
Ferreira, Isabel
Dekker, Jacqueline M.
Nijpels, Giel
Stehouwer, Coen D. A.
Title Metabolic syndrome in nondiabetic individuals associated with maladaptive carotid remodeling: the Hoorn study
Journal name American Journal of Hypertension   Check publisher's open access policy
ISSN 0895-7061
Publication date 2011-04
Year available 2011
Sub-type Article (original research)
DOI 10.1038/ajh.2010.256
Open Access Status Not yet assessed
Volume 24
Issue 4
Start page 429
End page 436
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background: 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.

Methods: 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.

Results: After adjustment for age, sex, height, prior cardiovascular disease (CVD), dyslipidemia, and smoking, MetS was independently associated with a greater IAD (regression coefficient (Β) per s.d. increase in MetS z-score (95% confidence interval), 0.45mm (0.28; 0.63)), LD (0.41mm (0.25; 0.58)) and CWS (5.56kPa (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 (0.020mm (0.006; 0.046)).

Conclusions: 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.
Keyword Arterial remodeling
Blood pressure
Carotid artery
Metabolic syndrome
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
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