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Arch Hellen Med, 24(2), March-April 2007, 178-185


Aortic distensibility in nondiabetic and type 2 diabetic subjects with and without metabolic syndrome

11st Department of Propedeutic Medicine, "Laiko" Hospital, Medical Schoïl, University of Athens, Athens,
2Department of Cardiology, "Laiko" Hospital, Athens, Greece

OBJECTIVE Loss of the elastic properties of the aorta occurs early in the atherosclerosis process and carries a poor prognosis. Metabolic syndrome is common and is associated with increased cardiovascular morbidity and mortality. This study deals with the relationship between metabolic syndrome and the elastic properties of the aorta in healthy individuals and subjects with type 2 diabetes mellitus. There are no such reports in the literature.

METHOD A total of 135 nondiabetic and 210 individuals with type 2 diabetes mellitus were studied. Metabolic syndrome was diagnosed using the NCEP-ATP III criteria. Aortic distensibility was assessed by highresolution ultrasonography.

RESULTS The prevalence of metabolic syndrome was significantly more common in patients with diabetes than in healthy individuals (64.8% vs 25.9%, respectively, P<0.001). In the control group, univariate analysis showed that subjects with metabolic syndrome had stiffer aortas (P=0.002). After multivariate adjustment, age (P<0.001), blood pressure (P<0.02), and albuminuria (P=0.06) were independently associated with aortic distensibility. In the diabetic subjects, no significant differences in aortic distensibility were found between those with and those without metabolic syndrome. After multivariate adjustment, duration of diabetes (P<0.001), pulse pressure (P=0.01), and glomerular filtration rate (P=0.01) were independently associated with aortic distensibility. These findings confirm previous studies which have shown that aortic distensibility is compromised in subjects with type 2 diabetes.

CONCLUSIONS Presence of the metabolic syndrome does not affect the elastic properties of the aorta in subjects either with or without type 2 diabetes mellitus. Of the components of the metabolic syndrome, increased blood pressure associated with aortic stiffness in both groups. Renal impairment is also related to aortic stiffness. Management of hypertension and prevention of nephropathy are expected to prevent aortic stiffening in both type 2 diabetic subjects and healthy individuals.

Key words: Aortic distensibility, Metabolic syndrome, Type 2 diabetes.

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