Clinical Investigation
Gender-Specific Association Between the Metabolic Syndrome and Arterial Stiffness in 8,300 Subjects

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Abstract

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.

Section snippets

Study Population

The medical records of 8,300 participants who underwent a health examination in the Third Xiangya Hospital of the Central South University were retrospectively analyzed from October 1, 2007, to September 30, 2011. The medical history and symptoms of each subject were confirmed by the consulting physicians. Subjects < 20 years and > 79 years were excluded. All subjects were not on medication and had no medical history of coronary artery disease, and had no history of smoking, stroke and renal

Demographic Data and Clinical Characteristics

A total of 8300 participants were included in this study of which 52.0% were men. The characteristics of these subjects are summarized in Table 1. There were no significant difference in age between men and women (48 ± 11.9 versus 48 ± 11.4 years, P = 0.623). baPWV in women was significantly lower than in men (1387 ± 291.6 versus 1457 ± 280.1 cm/s, P < 0.001). Most other variables were significantly lower in women than in men with the exception of HDL-C, which was higher in women (P < 0.001).

The Sex Difference of baPWV Stratified by Age

All subjects were

DISCUSSION

This study shows that women have lower baPWV than men in general, reaffirming that sex is an influential factor in baPWV.14 However, when stratified by age, women only had lower baPWV than men in the young and middle-aged populations. There is no significant difference in the elderly population, suggesting that differences in baPWV between men and women are age-related, in accordance with the study of Tomiyama et al13 in subjects without atherosclerotic risk factors. baPWV is an independent

ACKNOWLEDGMENT

The authors are grateful to Dr. Zhu (Weill Cornell Medical College) for helpful discussion and revision.

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    • Cited by (0)

    This study was supported, in part, by a grant from 12th Five-Year National Science and Technology Support Program (2012BAI37B05, to HY), a grant from the Key Science and Technology Projects in Hunan Province (2011SK2012, to FC) and a grant from the National Basic Research Program of China (2011CB512001, to HY).

    The authors have no other conflicts of interest to disclose

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