Metabolic syndrome and subclinical Atherosclerosis: association, remodeling and its associated risk factors

[摘要] This dissertation sought to examine the metabolic syndrome (MetS) and its association with subclinical atherosclerosis, carotid artery remodeling and its related risk factors, as well as the longitudinal effect of MetS status changes on carotid artery remodeling, in midlife women in three manuscripts.In the first manuscript, the MetS, via all definitions, was significantly associated with measures of subclinical atherosclerosis. The MetS components most strongly and consistently associated with carotid IMT and plaque were higher blood pressure and greater fasting glucose across all definitions considered in the current study.In the second manuscript, the MetS was significantly associated with maladaptive remodeling of the common carotid artery. Our findings also showed that the association between MetS and carotid artery remodeling was independent of select measure of inflammatory, hemodynamic, and metabolic risk factors.Finally, we observed differential maladaptive remodeling patterns of the common carotid artery with MetS status by race/ethnicity.In the third manuscript, midlife women with persistent MetS status were observed to have maladaptive remodeling of the carotid artery compared to those who never developed MetS over time after adjusting for potential confounders. Higher systolic blood pressure and larger waist circumference were significant and consistent determinants of adverse carotid artery remodeling in our current study.Each manuscript contributes uniquely to public health.Metabolic syndrome is associated with subclinical atherosclerosis in midlife women.Pharmacological intervention and lifestyle changes to target and prevent the metabolic syndrome construct or its components among midlife women may subsequently slow or reduce progression of atherosclerosis.

[发布机构] the University of Pittsburgh