Influence of the Metabolic Syndrome Versus the Sum of Its Individual Components on Left Ventricular Geometry in Young Adults (from the Bogalusa Heart Study)

      Current preventive cardiology guidelines strongly recommend identification of metabolic syndrome (MS), a constellation of cardiovascular risk factors, in clinical practice. These MS risk factors, individually or in a cluster, adversely alter left ventricular (LV) geometry. However, it is still unclear whether MS predicts risk, above and beyond its individual risk factors, for abnormal LV geometry. This aspect was examined in 830 asymptomatic patients (mean age 37 years, 69% whites, 41% men) as a part of the Bogalusa Heart Study. Patients with MS (as defined by the National Cholesterol Education Program Adult Treatment Panel III) showed adverse levels of echocardiographic parameters compared with patients without MS. With respect to MS components, patients with eccentric hypertrophy (EH) or concentric hypertrophy (CH) showed higher values of MS risk factors compared with patients with normal geometric pattern but no differences were noted between patients with normal and concentric remodeling. Of note, patients with concentric remodeling versus EH showed significantly higher systolic and diastolic blood pressure and fasting glucose levels. A model including only MS strongly predicted risk of EH (odds ratio [OR] 4.16, p <0.0001) and CH (OR 13.6, p <0.0001) compared with normal LV geometry. In a model including only individual MS risk factors, obesity (EH vs normal OR 14.4, p <0.0001), high blood pressure (CH vs normal OR 19.38, p <0.0001), and high fasting glucose levels (CH vs normal OR 4.02, p = 0.001) were significant predictors of abnormal LV geometry. However, the likelihood ratio test and comparisons of C-statistics for models including only individual MS risk factors versus models also including the MS variable were not significant. In conclusion, MS and its individual risk factors were strongly associated with LV geometry. However, MS did not predict risk of abnormal LV geometry independent of its individual components.
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