Effects of metabolic syndrome on arterial function in different age groups: The Advanced Approach to Arterial Stiffness study

Objective: The aim of the Advanced Approach to Arterial Stiffness study was to compare arterial stiffness measured simultaneously with two different methods in different age groups of middle-aged and older adults with or without metabolic syndrome (MetS). The specific effects of the different MetS components on arterial stiffness were also studied. Methods: This prospective, multicentre, international study included 2224 patients aged 40 years and older, 1664 with and 560 without MetS. Patients were enrolled in 32 centres from 18 European countries affiliated to the International Society of Vascular Health & Aging. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI) and the carotid-femoral pulse wave velocity (CF-PWV) in four prespecified age groups: 40-49, 50-59, 60-74, 75-90 years. In this report, we present the baseline data of this study. Results: Both CF-PWV and CAVI increased with age, with a higher correlation coefficient for CAVI (comparison of coefficients P<0.001). Age-adjusted and sex-adjusted values of CF-PWV and CAVI were weakly intercorrelated (r2=0.06, P<0.001). Age-adjusted and sex-adjusted values for CF-PWV but not CAVI were higher in presence of MetS (CF-PWV: 9.57±0.06 vs. 8.65±0.10, P<0.001; CAVI: 8.34±0.03 vs. 8.29±0.04, P=0.40; mean±SEM; MetS vs. no MetS). The absence of an overall effect of MetS on CAVI was related to the heterogeneous effects of the components of MetS on this parameter: CAVI was positively associated with the high glycaemia and high blood pressure components, whereas lacked significant associations with the HDL and triglycerides components while exhibiting a negative association with the overweight component. In contrast, all five MetS components showed positive associations with CF-PWV. Conclusion: This large European multicentre study reveals a differential impact of MetS and age on CAVI and CF PWV and suggests that age may have a more pronounced effect on CAVI, whereas MetS increases CF-PWV but not CAVI. This important finding may be due to heterogeneous effects of MetS components on CAVI. The clinical significance of these original results will be assessed during the longitudinal phase of the study. Copyright © 2018 The Author(s).

Topouchian J.1 , Labat C.2 , Gautier S.3 , Bäck M.2, 4 , Achimastos A.5 , Blacher J.1 , Cwynar M.6 , De La Sierra A. , Pall D.8 , Fantin F.9 , Farkas K.10 , Garcia-Ortiz L.11, 12 , Hakobyan Z.13 , Jankowski P.14 , Jelakovic A.15 , Kobalava Z. 16 , Konradi A.17 , Kotovskaya Y. 18, 19, 20 , Kotsani M.3 , Lazareva I.21 , Litvin A.22 , Milyagin V.23 , Mintale I.24 , Persson O.4 , Ramos R.25, 26, 27 , Rogoza A.22 , Ryliskyte L.28 , Scuteri A.29 , Sirenko Y.30 , Soulis G.31 , Tasic N.32 , Udovychenko M.33 , Urazalina S.34 , Wohlfahrt P.35 , Zelveian P.13 , Benetos A.2, 3 , Asmar R.36
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  • 1 Diagnosis and Therapeutic Center, Paris-Descartes University, AP-HP, Hôtel Dieu, Paris, France
  • 2 Inserm U1116, Université de Lorraine, Nancy, France
  • 3 Department of Geriatrics, CHRU Nancy, University Hospital of Nancy, Vandoeuvre les Nancy, Nancy, 54511, France
  • 4 Karolinska University Hospital, Cardiology Department, Stockholm, Sweden
  • 5 Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
  • 6 Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Kraków, Poland
  • 7 Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Terrassa, Spain
  • 8 Department of Medicine, University of Debrecen, Debrecen, Hungary
  • 9 Section of Geriatric Medicine, Department of Medicine, University of Verona, Verona, Italy
  • 10 Department of Angiology, Cardiometabolic Centre, Szent Imre University Teaching Hospital, Budapest, Hungary
  • 11 Primary Healthcare Research Unit, La Alamedilla Health Centre, Biomedical Research Institute of Salamanca (IBSAL), Salamanca, Spain
  • 12 Department of Biomedical and Diagnostic Sciences, University of Salamanca, Salamanca, Spain
  • 13 Centre of Preventive Cardiology, Institute of Cardiology, Yerevan, Armenia
  • 14 First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Kraków, Poland
  • 15 Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre, Zagreb, Croatia
  • 16 Department of Internal Medicine and Cardiology, Hopital 64, RUDN University, Moscow, Russian Federation
  • 17 Almazov Federal Medical Research Centre, St-Petersburg, Russian Federation
  • 18 RUDN University, Moscow, Russian Federation
  • 19 Department of Cardiology and Personified Medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation
  • 20 Russian Clinical and Research Centre of Gerontology, Moscow, Russian Federation
  • 21 Republican Scientific and Practice Centre 'Cardiology', Minsk, Belarus
  • 22 Russian Cardiology Research and Production Complex, Moscow, Russian Federation
  • 23 Department of Therapy, Ultrasound and Functional Diagnostics, Smolensk State Medical Academy, Smolensk, Russian Federation
  • 24 Cardiology Centre, P. Stradins University Hospital, Riga, Latvia
  • 25 Department of Medical Sciences, Institut Universitari D'Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
  • 26 University of Girona, Spain
  • 27 Primary Care Services, Biomedical Research Institute, Institut Catalàde la Salut, Girona, Spain
  • 28 Clinic of Cardiac and Vascular Diseases, Vilnius University, University Hospital Santaros Klinikos, Vilnius, Lithuania
  • 29 Policlinicio Tor Vergata, Universita di Roma Tor Vergata, Rome, Italy
  • 30 Institute of Cardiology, Kiev, Ukraine
  • 31 Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
  • 32 Cardiovascular Institute, Belgrade, Serbia
  • 33 Government Institution, L.T. Malaya Therapy Institute, National Academy of Medical Sciences of Ukraine, Kharkov, Ukraine
  • 34 Scientific and Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
  • 35 Center for Cardiovascular Prevention, Charles University and Thomayer Hospital, Prague, Czech Republic
  • 36 Foundation-Medical Research Institutes, Paris, France
Ключевые слова
Arterial tiffness; Cardio-ankle ascular index; ging; Large artery; Metabolic syndrome; Pulse wave velocity
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