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Egypt Heart J 62 (1): 39-52, March 2010
Metabolic Syndrome and its Impact on Vascular Damage Extent
AYMAN SADEK, MD; MAGDY NOUH AIN, MD; HANY FOUAD HANAA, MD;
RAMZY HAMED EL-MAWARDY, MD
Background: Metabolic syndrome is associated with increased risk of cardiovascular diseases in patients without a
cardiovascular history, there is nearly 3 fold increase cardiovascular related mortality compared to subjects without metabolic
syndrome.
Aim of the Work: Was to investigate the relation between metabolic syndrome and extent of vascular damage.
Methods and Results: We conducted a prospective observational study of 50 patients with history of coronary artery disease,
history of stroke TIA or Peripheral arterial disease between January 2005 and March 2006 at Ain Shams University hospitals,
Egypt. Patients having criteria of metabolic syndrome were identified. Echocardiography, carotid and femoral duplex, detection
of microalbuminuria were done for the study population The study population was divided into three groups: Group I included
12 patients with 3 metabolic risk factors, group II included 17 patients with 4 metabolic risk factors and group III included 21
patients with 5 metabolic risk factors. Comparison between the study groups as regard intima media thickness (IMT) of the
carotid and femoral arteries revealed that right carotid IMT was 0.97mm ±0.17, 1.13mm ±0.14 and 1.18mm ±0.17 in group I,II
and III respectively (p=0.002). Left carotid IMT was 0.97mm ±.19, 1.12mm ±0.12 and 1.19mm ±0.19 in group I,II and III
respectively [p=0.003 right femoral IMT was 0.98 mm ±0.23, 1.11mm ± 0.18 and 1.09 mm ±0.20 in group I,II and III respectively
(p=078)] left femoral IMT was 0.90mm ±.23, 1.10mm ±0.09 and 1.08 mm ±0.15 in group I,II and III respectively (p=0.003).
Comparison between the study groups as regard presence of carotid or femoral plaques revealed that presence of carotid plaque
was positive in 0.0 patient (0%) of group I and 5 patients (29.4%) of group II and 12 patient (57.1%) of group III (p=0.023).
Presence of femoral plaque was positive in 3 patients (25%) of group I and 4 patients (23.5%) of group II and 8 patient (38.1%)
of group III (p=0.56). Microalbuminuria was positive in 1 patient (8.3%) in group I, 4 patients (23.5%) of group II and 11
patients (52.4%) of group III (p=0.022). When comparing between the study groups as regard number of vascular beds affected
in each group (coronary, cerebral and peripheral vascular beds), we found that group I 10 patients (40%) was having one vascular
bed affected, 2 patients (8.7%) having two vascular beds affected and 0.0 patient (0%) having three vascular beds affected, in
group II we found that 10 patients 40% was having one vascular beds affected 7 patients (30.4%) having two vascular beds
affected and 0.0 (0%) patient having three vascular beds affected. In group III we found that 5 patients (20%) was having one
vascular beds affected 14 patients (60.5%) having two vascular beds affected and 2 (100%) patients having three vascular beds
affected. Right femoral IMT was 1.06±0.19mm when one vascular bed affected, 1.13±0.22mm when two vascular beds affected
and 1.12±0.17mm when three vascular beds affected (p=0.59). Left femoral IMT was 0.9±0.22mm when one vascular bed
affected, 1.09±0.22mm when two vascular beds affected and 1.09±0.15mm when three vascular beds affected (p=0.003)
Comparison between the presence of positive microalbuminuria and number of vascular beds affected revealed that it was
positive in 2 patients (8.0%) when one vascular bed affected, 12 patients (52.2%) when two vascular beds affected and 2 patients
(100%) when three vascular beds affected (p=0.001).
Conclusions: Metabolic syndrome is constellation of risk factors for atherosclerosis and increase in traits of metabolic
syndrome is associated with increase in extent of vascular damage. The increase in traits of metabolic syndrome is associated
with increase in carotid and femoral IMT and presence of microalbuminuria. The presence of thickened carotid and femoral
IMT and presence of microalbuminuria is associated with increase in extent of vascular damage.
Key Words: Metabolic syndrome – Vascular damage.
Faculty of Medicine, Ain Shams University.
Manuscript received 10 Sep., 2009; revised 20 Oct., 2009;
accepted 21 Oct., 2009.
Address for Correspondence: Dr. Ayman Sadek, Faculty of
Medicine, Ain Shams University.
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