The relationship between the metabolic syndrome and arterial wall thickness: A mosaic still to be interpreted

Background and aims We aimed to identify clusters of metabolic syndrome (MetS) components, risky for extremely high intima-media thickness. Methods We studied 41,513 volunteers (men and women) from eleven cohorts worldwide, participating in the MARE (Metabolic syndrome and Artery REsearch) Consortium. Results Specific clusters of MetS components - high triglycerides-high blood pressure-abdominal obesity (TBW), low HDL cholesterol-high blood pressure-abdominal obesity (HBW), high glucose-high blood pressure-abdominal obesity (GBW) - were accompanied by a 50–90% significantly greater likelihood of presenting extremely high intima-media thickness (via ultrasound of carotid artery, CCA IMT), after controlling for age, sex, smoking, non-HDL cholesterol, and presence of diabetes mellitus. This likelihood is comparable to the effect of being 7–8 years older or of being a cigarette smoker or of having non-HDL cholesterol 50 mg/dl higher. Conclusions The consistent association of specific clusters of MetS components with extremely thick (older) large artery cross-culturally suggests that identification of those clusters in clinical practice will facilitate a personalized health care and a better – i.e. more healthy and cost-effective - prevention of major cardiovascular (CV) events.