Background: The objective of this study was to determine the sex-specific association between the metabolic syndrome (MetS) and arterial stiffness.
Methods: In this cross-sectional study, 3981 women and 4319 men aged 20 to 79 years were analyzed. All participants underwent the measurement of waist circumference, blood pressure (BP), brachial-ankle pulse wave velocity (baPWV) and blood chemistry. baPWV levels were compared between men and women using the Mann-Whitney's U test. Subjects with or without MetS and its components or specific clusters of MetS components in the different sexes were compared by the Kruskal-Wallis test. Binary logistic regression analysis was performed to evaluate the relationship between baPWV and the MetS components.
Results: Women had lower baPWV than men in young and middle-aged subjects (P < 0.001), but there was no difference in the elderly subjects. baPWV levels in women were higher than in men with MetS and its components except for high-density lipoprotein cholesterol (HDL-C; P < 0.01). The combination of elevated triglycerides, elevated BP and elevated fasting glucose (with obesity or low HDL-C) had a greater baPWV than the other clusters. All the metabolic variables were positively correlated with baPWV except for HDL-C negatively correlating in women (P < 0.001), whereas age, BP and fasting glucose were moderately associated with baPWV in men (P < 0.001). Among the MetS components, BP had the strongest association with baPWV.
Conclusions: The MetS and its components affect arterial stiffness more severely in women than in men. More importance to women with MetS should be given.