Objective: Carotid intima-media thickness (CIMT), a surrogate marker of subclinical atherosclerosis, has been consistently linked to cardiovascular disease (CVD). Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors; however, the clinical implications of CIMT, which is the sum of the intima (IT) and media thickness (MT), in age-related groups with MetS has not been established.
Methods: Among 3377 patients who underwent B-mode ultrasound of both common carotid arteries at our institution, 783 subjects (M:F = 405:378; mean age, 57 ± 12 years) without coronary artery disease (CAD) confirmed by coronary angiography (CAG) were enrolled in this study. The individual measurements of IT, MT, and CIMT were compared in different age groups, which were divided into tertiles as follows: first tertile (< 52 years of age; 278 subjects; M:F = 192:86; mean age, 44 ± 7 years); second tertile (53-64 years of age; 265 subjects; M:F = 108:157; mean age, 59 ± 3 years); and third tertile (65-87 years of age; 240 subjects; M:F = 78:162; mean age, 71 ± 5 years).
Results: 102 (37%), 111 (42%), and 116 (48%) patients were diagnosed with MetS according to the National Cholesterol Education Program (NCEP) criteria. There were significant differences in the right maximal CIMT (0.848 ± 0.22 vs. 0.758± 0.17 mm, p<0.001), mean CIMT (0.729 ± 0.18 vs. 0.658 ± 0.14 mm, p<0.0001), right MT (0.509 ± 0.18 vs. 0.433 ± 0.14 mm, p<0.001), left maximal IMT (0.816 ± 0.18 vs. 0.749 ± 0.16 mm, p = 0.036), left mean IMT (0.719 ± 0.17 vs. 0.656 ± 0.13 mm, p = 0.018), and left MT (0.504 ± 0.17 vs. 0.424 ± 0.13 mm, p = 0.003) in the lowest tertile group with and without MetS. In the highest tertile group, the CIMT, IT, and MT did not differ in patients with and without MetS. Based on multiple logistic regression analysis, the right MT was closely related to MetS (Table) .
Conclusions: The CIMT, especially the right MT, is a useful surrogate marker of subclinical atherosclerosis in young adults with MetS.
Key words: carotid artery, arterial media, subclinical atherosclerosis, young, metabolic syndrome
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Table. CIMT and MT affecting the presence of MetS
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Unadjusted OR |
95% CI |
P value |
Adjusted OR* |
95% CI |
P value |
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Rt. max IMT |
4.032 |
2.112-7.696 |
0.0001 |
3.721 |
1.686-8.212 |
0.001 |
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Rt. mean IMT |
5.806 |
2.535-13.295 |
0.0001 |
4.615 |
1.652-12.892 |
0.004 |
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Rt. MT |
7.634 |
3.065-19.011 |
0.0001 |
6.537 |
2.168-19.711 |
0.001 |
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Lt. max IMT |
2.770 |
1.071-7.165 |
0.036 |
2.154 |
0.611-7.598 |
0.233 |
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Lt. mean IMT |
3.142 |
1.030-9.586 |
0.044 |
2.786 |
0.609-12.748 |
0.187 |
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Lt. MT |
3.434 |
1.118-10.551 |
0.031 |
3.373 |
0.744-15.301 |
0.115 |
IMT: intima-media thickness, MT: media thickness, MetS: metabolic syndrome, OR: odds ratio, CI: confidence interval, Rt: right, Lt: left
*Adjusted for age, gender, total cholesterol, and HbA1c
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