Association of metabolic syndrome and electrocardiographic markers of subclinical cardiovascular disease

Elffers, T. W., de Mutsert, R., Lamb, H. J., Maan, A. C., Macfarlane, P. W., Willems van Dijk, K., Rosendaal, F. R., Jukema, J. W. and Trompet, S. (2017) Association of metabolic syndrome and electrocardiographic markers of subclinical cardiovascular disease. Diabetology and Metabolic Syndrome, 9, 40. (doi: 10.1186/s13098-017-0238-9) (PMID:28539979) (PMCID:PMC5441065)

Abstract

The metabolic syndrome (MetS) and its components are well-established risk factors for cardiovascular diseases (CVD). It is inconclusive whether MetS and MetS score are associated with electrocardiographic markers of subclinical CVD, therefore we investigated this in a population without pre-existing CVD. We performed a cross-sectional analysis in the Netherlands Epidemiology of Obesity study, a population-based cohort including 6671 participants aged 45-65. We excluded participants with pre-existing CVD (n = 499) or missing MetS components (n = 58). MetS was defined based on a modified definition of Adult Treatment Panel III. Subclinical CVD parameters were determined with 12-lead ECGs. MetS score was defined as number of abnormal MetS components and obesity as Body Mass Index (BMI) ≥30 kg/m(2). We performed weighted adjusted linear regression analyses. Our study population (n = 6114) had a mean (SD) BMI of 26.3 (4.4) kg/m(2) and MetS was present in 24% of participants. All ECG parameters differed between participants with and without MetS. Per additional MetS component, heart rate was 0.17 SD (95% CI 0.15, 0.19) higher, P wave duration, QRS complex duration and corrected QT interval were longer [0.07 SD (0.05, 0.10), 0.04 SD (0.01, 0.06) and 0.05 SD (0.02, 0.08) respectively], P wave axis, T wave axis and QRS axis were lower [-0.10 SD (-0.12, -0.07), -0.07 SD (-0.10, -0.05) and -0.19 SD (-0.22, -0.16)] and percentage small Q-waves also increased per additional MetS component. Associations were stronger in non-obese than obese participants. In joint modelling of all MetS components, increased waist circumference showed strongest associations with ECG parameters. Metabolic syndrome score and its individual components, in particular abdominal obesity, are associated with ECG markers of subclinical CVD, showing the importance of limiting the amount of MetS components in both obese and non-obese persons.

• Item Type: Articles
• Keywords: Cardiovascular disease, metabolic syndrome, obesity.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macfarlane, Professor Peter
• Authors: Elffers, T. W., de Mutsert, R., Lamb, H. J., Maan, A. C., Macfarlane, P. W., Willems van Dijk, K., Rosendaal, F. R., Jukema, J. W., and Trompet, S.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Diabetology and Metabolic Syndrome
• Publisher: BioMed Central
• ISSN: 1758-5996
• ISSN (Online): 1758-5996
• Copyright Holders: Copyright © 2017 The Authors
• First Published: First published in Diabetology and Metabolic Syndrome 9:40
• Publisher Policy: Reproduced under a Creative Commons License