Purpose We prospectively evaluated the effect of metabolic syndrome (MetS) on geometry and function of left ventricle (LV), carotid intima-media thickness (IMT) and arterial stiffness in a Korean population. Methods We analyzed a cohort of 708 adult subjects (mean age; 55.5±8.49yrs; male; 41%) from ARIRANG study. Participants were categorized by number of MetS characteristics: (1) Absent (0 criteria, n=70); (2) Pre-MetS (1-2 criteria, n=360); (3) MetS (≥3 criteria, n=278). All subjects were taken echocardiography and pulse wave analyzer for arterial stiffness. We measured the IMT on the far wall at 10 mm proximal to the bifurcation of the carotid artery. We defined MetS by ATP III guideline. ANCOVA was used to determine whether values are significantly different among category, when adjusted for age and sex. Results The incidence of MetS was 37.6 % in men and 40.5 % in women. LV systolic function and relative wall thickness were similar among groups. But, LA volume index, LV diastolic dimension (LVIDd), and LV mass index exhibited a stepwise increase from the absent to the pre-MetS to the MetS (LA volume index, ml/m²: 18.7±4.4, 20.0±5.3, 21.5±6.2, p=0.011; LVIDd, cm: 4.97±0.44, 5.05±0.61 5.18±0.61, p<0.01; LV mass index, g/m²: 66.6±18.1, 75.3±19.7, 79.5±26.3, p=0.014). E/A ratio decreased progressively (1.12±0.33, 1.01±0.33, 0.90±0.26, p<0.01) and E/E’ ratio increased significantly (8.42±2.06, 9.75±2.81, 10.79±3.49, p<0.01) among groups. Mean carotid IMT exhibited a stepwise increase (IMT mean, mm: 0.588±0.119, 0.605±0.138, 0.653±0.180, p<0.01). Heart to radial (hrPWV) and femoral to ankle PWV (faPWV) also increased significantly (hrPWV, m/sec: 7.19±0.98 7.45±1.26 7.68±1.24, p=0.05; faPWV, m/sec: 9.25±1.36 9.97±1.34 10.25±1.28, p<0.01). Conclusions The degree of MetS clustering was strongly related to eccentric LV hypertrophic geometry (LVIDd and LV mass index), diastolic dysfunction (LA volume index, E/A ratio, and E/E’ ratio), structural and functional changes of artery (carotid IMT, hrPWV and faPWV). These associations suggest that insulin resistance could influence the structural and functional changes of arterial and LV.
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