Endothelium-dependent vasodilation predicts the development of the metabolic syndrome.

Abstract

Different techniques to evaluate endothelium-dependent vasodilation (EDV) in resistance and conduit arteries have been described and have been associated with the occurrence of the metabolic syndrome (MetS) in cross-sectional studies. This study aimed to evaluate whether EDV in resistance and conduit arteries could predict future development of the MetS in the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS) study. In the population-based PIVUS study (1016 subjects all aged 70 at baseline), the invasive forearm technique with acetylcholine given in the brachial artery (resistance arteries, EDV) and the brachial artery ultrasound technique with the measurement of flow-mediated dilatation (conduit artery, FMD) were evaluated. Six hundred and twenty-four subjects free of the MetS (NCEP/ATPIII criteria) at the age of 70 were reinvestigated at the age of 75. During the 5-year follow-up, 109 new subjects developed the MetS. EDV, but not FMD, predicted the development of the MetS (OR 0.78 for a 1 SD increase in EDV, 95%CI 0.62-0.97, P = 0.033). Of the five components of the MetS, EDV could significantly predict the development of the glucose (P = 0.02), waist circumference (P = 0.01) and the triglyceride components (P = 0.002), but not significantly so the HDL (P = 0.09) and blood pressure components (P = 0.92). EDV in resistance arteries, but not in the brachial conduit artery (FMD), was a predictor of future development of the MetS, mainly by prediction of future impairments in fasting glucose, serum triglycerides and waist circumference in an elderly cohort.