Carotid intima-media thickness and metabolic syndrome in a rural population: Results from the Baependi Heart Study

Glaucylara Reis Geovanini; Iguaracy Pinheiro de Sousa; Samantha Kuwada Teixeira; Miguel José Francisco Neto; Luz Marina Gómez Gómez; Guilherme Ciconelli Del Guerra; Alexandre Costa Pereira; Jose Eduardo Krieger

doi:10.1016/j.ijchy.2020.100043

Carotid intima-media thickness and metabolic syndrome in a rural population: Results from the Baependi Heart Study

Int J Cardiol Hypertens. 2020 Jul 22:6:100043. doi: 10.1016/j.ijchy.2020.100043. eCollection 2020 Sep.

Authors

Glaucylara Reis Geovanini^{1

2}, Iguaracy Pinheiro de Sousa¹, Samantha Kuwada Teixeira¹, Miguel José Francisco Neto^{3

4}, Luz Marina Gómez Gómez¹, Guilherme Ciconelli Del Guerra³, Alexandre Costa Pereira¹, Jose Eduardo Krieger¹

Affiliations

¹ Genetics and Molecular Cardiology Laboratory at InCor-Heart Institute, Medical School, University of São Paulo-USP, São Paulo, SP, Brazil.
² HCor Research Institute-Hospital do Coracão (HCor), São Paulo, SP, Brazil.
³ Department of Imaging of Hospital Israelita Albert Einstein - HIAE, São Paulo, Brazil.
⁴ Institute of Radiology - InRad, Medical School, University of São Paulo - USP, São Paulo, Brazil.

Abstract

Background and aims: Carotid intima-media thickness (cIMT) is a strong predictor of cardiovascular events and associated with metabolic syndrome (MetS). MetS is a cluster of cardiovascular risk factors, but the association structure between specific factors and disease development is not well-established in rural populations. We described the association structure between MetS factors and cIMT in a sample from rural Brazil.

Methods: We studied 1937 participants from the Baependi Heart Study who underwent carotid ultrasound exam. We used ATP-III-2001 for MetS definition and linear mixed-effects models, adjusting by the family structure, to assess independent associations between the cardiovascular risk factors which define MetS and cIMT.

Results: The sample's mean age was 46 ± 16y, 61% female, 73% white, mean body-mass-index 26±5 kg/m², mean cIMT 0.53 ± 0.16 mm, with 35% of the sample classified with MetS. As expected, cIMT demonstrated a linear relationship with increasing age, and cIMT higher values were observed for MetS (0.58 ± 0.16 mm) compared to non-MetS (0.49 ± 0.14 mm). Considering models for cIMT with MetS and all of its factors, we found that blood pressure, glucose and obesity were independently associated with cIMT, but not HDL or triglycerides.

Conclusions: cIMT showed a linear relationship with increasing age. Blood pressure, obesity, and glucose were independently associated with cIMT, but not HDL-cholesterol or triglycerides. In a rural population, hypertension, diabetes and obesity play a more important role than lipids in determining cIMT interindividual variability.

Keywords: Baependi Heart Study; Carotid intima-media thickness; Carotid ultrasound; MetS; Subclinical atherosclerosis; cIMT.