| 1. |
- Girkantaite, Zivile, et al.
(author)
-
Laser Doppler flowmetry evaluation of skin microvascular endothelial function in patients with metabolic syndrome
- 2022
-
In: Microvascular Research. - : Elsevier BV. - 0026-2862. ; 142
-
Journal article (peer-reviewed)abstract
- Background: Metabolic syndrome (MetS) is associated with high cardiovascular morbidity and mortality, and endothelial dysfunction is an early pathogenetic event in the MetS. Lifestyle changes and pharmacological intervention might partly restore endothelial function in MetS. Whereas an optimal non-invasive test for endothelial dysfunction is still being sought, the aim of this study was to assess the relationship between changes in skin microvascular endothelial function, detected by Laser Doppler flowmetry, and cardiovascular risk factors (CVRFs) of patients with MetS. Design and methods: 3081 patients (1865 women and 1216 men, mean age 53 ± 6 years) with MetS were enrolled in the study, which was conducted during the period of 2010–2014 at Vilnius University Hospital Santaros Klinikos. Skin microvascular endothelial function was evaluated using the Laser Doppler flowmetry in combination with the post-occlusive reactive hyperaemia test. The percentage change of flow from peak to the rest flow (PF-RF) was calculated and used as the main measure of endothelial function. Results: The study showed that decrease in flow-mediated dilatation reflected by PF-RF was associated with increased triglycerides (p = 0.002), male sex (p < 0.001), and diabetes (p = 0.002). Patients with quite a few CVRFs (body mass index ≥25 kg/m2, smoking, diabetes, arterial hypertension, a positive history of dyslipidaemia) had significantly lower PF-RF score than patients only with one of these risk factors (p < 0.001). Conclusions: Changes in skin microvascular endothelial function are significantly associated with most CVRFs and depend on the number of CVRFs.
|
|
| 2. |
- Laucyte-Cibulskiene, Agne, et al.
(author)
-
Arterial stiffness in regards to kidney function in middle-aged subjects with metabolic syndrome : Lithuanian high-risk cohort
- 2021
-
In: Blood Pressure Monitoring. - 1359-5237. ; 26:3, s. 191-195
-
Journal article (peer-reviewed)abstract
- Objective The current study aimed to check whether early vascular aging, measured as carotid-femoral pulse wave velocity (cfPWV), is related to kidney function, measured as creatinine-based estimated glomerular filtration (eGFR) and urinary albumin-to-creatinine ratio (UACR), in middle-aged subjects with metabolic syndrome. Methods Participants were recruited from Lithuanian high-risk cohort (LitHiR). The cohort consists of middle-aged individuals with high cardiovascular risk but without overt cardiovascular disease. Participants underwent baseline and second visit hemodynamics measurement, including aortic mean arterial pressure (MAP), cfPWV, crPWV, carotid-intima media thickness measurement (CIMT) and biochemical analysis and all fulfilled NCEP/ ATPIII criteria for metabolic syndrome diagnosis. First of all, we had determined correlations among hemodynamic measurement and eGFR together with albuminuria, expressed as UACR. Then we compared subjects who experienced significant eGFR decline with the remaining population and determining factors influencing this. Results A total of 689 subject data were eligible for analysis. We observed relationship between cfPWV and MAP, crPWV, glucose, BMI, C-reactive protein, waist circumference except kidney function measured as eGFR at the baseline and at the second visit. eGFR was not associated with MAP or albuminuria. Baseline but not second visit UACR significantly positively correlated with cfPWV (r-spearman = 0.146, P = 0.003) and MAP (r-spearman = 0.142, P = 0.005). eGFR decline was mainly observed in subjects with higher baseline eGFR and was independently influenced by increase in cfPWV. Conclusion In middle-aged subjects with prevalent metabolic syndrome eGFR decline is related to aortic and not peripheral arterial stiffening. Better baseline kidney function could be possibly an effect of glomerular hyperfiltration, and it allows us to conclude that this phenomenon indicates early vascular damage and it should be addressed seriously in metabolic syndrome patients with normal kidney function. Blood Press Monit 26: 191–195
|
|
| 3. |
- Laucyte-Cibulskiene, Agne, et al.
(author)
-
Clusters of risk factors in metabolic syndrome and their influence on central blood pressure in a global study
- 2022
-
In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1
-
Journal article (peer-reviewed)abstract
- The effect of metabolic syndrome (MetS) and clusters of its components on central blood pressure (CBP) has not been well characterized. We aimed to describe the effect of MetS and clusters of its components on CBP in a large population and to identify whether this effect differs in men and women. We studied 15,609 volunteers (43% women) from 10 cohorts worldwide who participated in the Metabolic syndrome and Artery REsearch Consortium. MetS was defined according to the NCEP-ATP III criteria (GHTBW, glucose, high-density lipoprotein cholesterol, triglyceride, blood pressure, waist circumference). CBP was measured noninvasively and acquired from pulse wave analysis by applanation tonometry. MetS was associated with a 50% greater odds of having higher CSBP. After controlling for age, male sex, non HDL cholesterol, diabetes mellitus, and mean arterial pressure, only specific clusters of MetS components were associated with a higher CSBP; and some of them were significant in women but not in men. We identified “risky clusters” of MetS variables associated with high CSBP. Future studies are needed to confirm they identify subjects at high risk of accelerated arterial aging and, thus, need more intensive clinical management.
|
|
| 4. |
- Laučytė-Cibulskienė, Agnė, et al.
(author)
-
Inflammaging and Vascular Function in Metabolic Syndrome : The Role of Hyperuricemia
- 2022
-
In: Medicina (Lithuania). - : MDPI AG. - 1010-660X .- 1648-9144. ; 58:3
-
Journal article (peer-reviewed)abstract
- Background and Objectives: Early vascular aging determines a more rapid course of age-related arterial changes. It may be induced by a proinflammatory state, caused by hyperuricemia and metabolic syndrome and their interrelationship. However, the impact of serum uric acid (SUA) on early arterial stiffening and vascular function remains uncertain. Materials and Methods: A total of 696 participants (439 women aged 50–65 and 257 men aged 40–55) from the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program were enrolled in the study. They underwent anthropometric measurements and laboratory testing along with arterial parameters’ evaluation. Quality carotid stiffness (QCS), carotid-radial pulse wave velocity (crPWV), carotid-femoral pulse wave velocity (cfPWV), flow-mediated dilatation (FMD), and carotid intima-media thickness (CIMT) were registered. Results: We found that hyperuricemia was significantly associated with inflammation, registered by high-sensitivity C-reactive protein in both sexes. A very weak but significant association was observed between cfPWV and SUA in men and in women, while, after adjusting for risk factors, it remained significant only in women. A positive, weak, but significant association was also observed for QCS, both right and left in women. No relationship was observed between crPWV, FMD, CIMT, and SUA.
|
|
| 5. |
- Nilsson, Peter M., et al.
(author)
-
Characteristics of healthy vascular ageing in pooled population-based cohort studies : the global Metabolic syndrome and Artery REsearch Consortium
- 2018
-
In: Journal of Hypertension. - 1473-5598. ; 36:12, s. 2340-2349
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: Arterial ageing is characterized by increasing arterial stiffness as measured by pulse wave velocity (PWV). This process is enhanced in participants with early vascular ageing (EVA), but slowed in participants with healthy vascular ageing (HVA). We aimed to describe characteristics of EVA and HVA in a transcontinental study including 11 cohorts.METHODS: In all, 18 490 participants from the global MARE Consortium, free of cardiovascular disease, participated with data on PWV and cardiometabolic risk factors. We defined HVA as the lowest 10% and EVA as the highest 10% of the standardized PWV distribution, adjusted for age intervals. HVA individuals were compared with the 90% of non-HVA individuals with ANCOVA, adjusted for age, sex and hypertension.RESULTS: The 1723 HVA participants were at the same age as the rest of the population, more likely women (59.4 vs 57.0%), and with significantly lower levels of established cardiovascular risk factors (blood pressure, lipids, glucose). Similarly, the prevalence rate of obesity, diabetes mellitus, hypertension and the metabolic syndrome was lower in the HVA participants. In the presence of similar levels of cardiovascular risk factors, HVA participants in the 50-64 years of age group presented lower PWV 5.8 (SD 0.5) vs. 7.4 (1.4) m/s (P < 0.0001) than control individuals in the 35-49 years of age group, corresponding to an estimated difference in chronological age of 14 years.CONCLUSION: Participants with healthy vascular ageing (HVA), belonging to the lowest end of the PWV distribution, are in general characterized by an up to 14 years estimated younger biological (vascular) age than those with higher PWV values, and have lower levels of risk factors.
|
|
| 6. |
- Scuteri, Angelo, et al.
(author)
-
Arterial stiffness and influences of the metabolic syndrome: A cross-countries study.
- 2014
-
In: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 233:2, s. 654-660
-
Journal article (peer-reviewed)abstract
- Specific clusters of metabolic syndrome (MetS) components impact differentially on arterial stiffness, indexed as pulse wave velocity (PWV). Of note, in several population-based studies participating in the MARE (Metabolic syndrome and Arteries REsearch) Consortium the occurrence of specific clusters of MetS differed markedly across Europe and the US. The aim of the present study was to investigate whether specific clusters of MetS are consistently associated with stiffer arteries in different populations. We studied 20,570 subjects from 9 cohorts representing 8 different European countries and the US participating in the MARE Consortium. MetS was defined in accordance with NCEP ATPIII criteria as the simultaneous alteration in ≥3 of the 5 components: abdominal obesity (W), high triglycerides (T), low HDL cholesterol (H), elevated blood pressure (B), and elevated fasting glucose (G). PWV measured in each cohort was "normalized" to account for different acquisition methods. MetS had an overall prevalence of 24.2% (4985 subjects). MetS accelerated the age-associated increase in PWV levels at any age, and similarly in men and women. MetS clusters TBW, GBW, and GTBW are consistently associated with significantly stiffer arteries to an extent similar or greater than observed in subjects with alteration in all the five MetS components - even after controlling for age, sex, smoking, cholesterol levels, and diabetes mellitus - in all the MARE cohorts. In conclusion, different component clusters of MetS showed varying associations with arterial stiffness (PWV).
|
|
| 7. |
- Scuteri, Angelo, et al.
(author)
-
Metabolic syndrome across Europe: Different clusters of risk factors
- 2015
-
In: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4881 .- 2047-4873. ; 22:4, s. 486-491
-
Journal article (peer-reviewed)abstract
- Background: Metabolic syndrome (MetS) remains a controversial entity. Specific clusters of MetS components - rather than MetS per se - are associated with accelerated arterial ageing and with cardiovascular (CV) events. To investigate whether the distribution of clusters of MetS components differed cross-culturally, we studied 34,821 subjects from 12 cohorts from 10 European countries and one cohort from the USA in the MARE (Metabolic syndrome and Arteries REsearch) Consortium. Methods: In accordance with the ATP III criteria, MetS was defined as an alteration three or more of the following five components: elevated glucose (G), fasting glucose >= 110 mg/dl; low HDL cholesterol, <40mg/dl for men or <50 mg/dl for women; high triglycerides (T), >= 150 mg/dl; elevated blood pressure (B), >= 130/ >= 85 mmHg; abdominal obesity (W), waist circumference >102 cm for men or >88 cm for women. Results: MetS had a 24.3% prevalence (8468 subjects: 23.9% in men vs. 24.6% in women, p < 0.001) with an age-associated increase in its prevalence in all the cohorts. The age-adjusted prevalence of the clusters of MetS components previously associated with greater arterial and CV burden differed across countries (p < 0.0001) and in men and women (p < 0.0001). In details, the cluster TBW was observed in 12% of the subjects with MetS, but was far more common in the cohorts from the UK (32.3%), Sardinia in Italy (19.6%), and Germany (18.5%) and less prevalent in the cohorts from Sweden (1.2%), Spain (2.6%), and the USA (2.5%). The cluster GBW accounted for 12.7% of subjects with MetS with higher occurrence in Southern Europe (Italy, Spain, and Portugal: 31.4, 18.4, and 17.1% respectively) and in Belgium (20.4%), than in Northern Europe (Germany, Sweden, and Lithuania: 7.6, 9.4, and 9.6% respectively). Conclusions: The analysis of the distribution of MetS suggested that what follows under the common definition of MetS is not a unique entity rather a constellation of cluster of MetS components, likely selectively risky for CV disease, whose occurrence differs across countries.
|
|
| 8. |
- Scuteri, Angelo, et al.
(author)
-
The relationship between the metabolic syndrome and arterial wall thickness : A mosaic still to be interpreted
- 2016
-
In: Atherosclerosis. - : Elsevier BV. - 0021-9150. ; 255, s. 11-16
-
Journal article (peer-reviewed)abstract
- 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.
|
|
