THE METABOLIC SYNDROME DOES NOT ADD TO CAROTID ATHEROSCLEROSIS BEYOND THAT EXPECTED BY RISK FACTOR COUNTING OR RISK SCORING

Objective: The aim of this study was to assess if the Metabolic Syndrome (MS) has any add-on effect on subclinical atherosclerosis beyond that expected by risk factors (RF) counting or risk scoring. Methods: Intima-media thickness (IMT) of carotid arteries was assessed by using B-mode ultrasound in 1805 patients (56±13 y; 52% women) attending a cardiovascular prevention program. Patients with (cases) or without (controls) MS according to NCEP ATP III criteria were 1:1 matched for sex, age and either the number of conventional RF (Analysis 1) or the Framingham risk score (Analysis 2). For Analysis 1 not more than 2 components of the MS were accepted as RF in the control group. Results: Case:control matches were 211 for Analysis 1 and 244 for Analysis 2. No significant differences in carotid IMTmean and carotid IMTmax were found between cases and controls in both analyses (Analysis 1: IMTmean 1.030.38 vs 1.070.37; IMTmax 1.900.96 vs 1.950.90. cases and controls, respectively; Analysis 2: IMTmean 1.030.36 vs 1.010.33; IMTmax 1.910.94 vs 1.830.81, cases and controls, respectively; all p>0.1). Conclusions: According to our results the metabolic syndrome does not add to the extent of carotid subclinical atherosclerosis beyond that expected by RF counting or risk scoring. These findings do not support any particular armful synergism between components of metabolic syndrome in determining carotid atherosclerosis. Funding: No commercial funding is disclosed.