The Korean journal of internal medicine

  • 제39권4호
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  • Pages.612-624
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  • 2024
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
The Korean Association of Internal Medicine (대한내과학회)
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Estimated pulse wave velocity as a forefront indicator of developing metabolic syndrome in Korean adults

  • Hyun-Jin Kim (Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Byung Sik Kim (Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Dong Wook Kim (Division of Endocrinology, Diabetes and Hypertension, Center for Weight Management and Wellness, Brigham and Women's Hospital, Harvard Medical School) ;
  • Jeong-Hun Shin (Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine)
  • 투고 : 2024.01.13
  • 심사 : 2024.03.28
  • 발행 : 2024.07.01
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초록

Background/Aims: The predictive value of the estimated pulse wave velocity (ePWV) for the development of metabolic syndrome has not yet been extensively explored. This study aimed to fill this gap by evaluating ePWV as a potential predictor of metabolic syndrome development in middle-aged Korean adults. Methods: Using prospective data obtained from the Ansan-Ansung cohort database, participants without metabolic syndrome at baseline were studied. ePWV was calculated using specific equations based on age and blood pressure. The primary outcome was the incidence of metabolic syndrome during a median follow-up period of 187 months. Results: Among the 6,186 participants, 2,726 (44.1%) developed metabolic syndrome during the follow-up period. ePWV values were categorized into tertiles to assess their predictive value for the development of metabolic syndrome. An ePWV cut-off of 7.407 m/s was identified as a predictor of metabolic syndrome development, with a sensitivity of 0.743 and a specificity of 0.464. Participants exceeding this cut-off, especially those in the third tertile (8.77-14.63 m/s), had a notably higher risk of developing metabolic syndrome. Specifically, the third tertile exhibited a 52.8% cumulative incidence compared with 30.8% in the first tertile. After adjustments, those in the third tertile faced a 1.530-fold increased risk of metabolic syndrome (95% confidence interval, 1.330-1.761). Conclusions: ePWV is a significant predictor of the development of metabolic syndrome. This finding underscores the potential of ePWV as a cardiometabolic risk assessment tool and can thus provide useful information for primary prevention strategies.

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과제정보

The authors thank the Korean Society of Cardiometabolic Syndrome for providing funding for this online survey.

참고문헌

  1. Chae J, Seo MY, Kim SH, Park MJ. Trends and risk factors of metabolic syndrome among Korean adolescents, 2007 to 2018. Diabetes Metab J 2021;45:880-889. 
  2. Fahed G, Aoun L, Bou Zerdan M, et al. Metabolic syndrome: updates on pathophysiology and management in 2021. Int J Mol Sci 2022;23:786. 
  3. Nilsson PM, Tuomilehto J, Ryden L. The metabolic syndrome - what is it and how should it be managed? Eur J Prev Cardiol 2019;26(2_suppl):33-46. 
  4. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-2752. 
  5. Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018;20:12. 
  6. O'Neill S, O'Driscoll L. Metabolic syndrome: a closer look at the growing epidemic and its associated pathologies. Obes Rev 2015;16:1-12. 
  7. Anderson TJ. Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk. Can J Cardiol 2006;22 Suppl B(Suppl B):72B-80B. 
  8. Cons NC. Dental care under medicaid; the implementation of title XIX in the state of New York. J Public Health Dent 1967;27:123-125. 
  9. Sequi-Dominguez I, Cavero-Redondo I, Alvarez-Bueno C, Pozuelo-Carrascosa DP, Nunez de Arenas-Arroyo S, Martinez-Vizcaino V. Accuracy of pulse wave velocity predicting cardiovascular and all-cause mortality. a systematic review and meta-analysis. J Clin Med 2020;9:2080. 
  10. Kim HL, Kim SH. Pulse wave velocity in atherosclerosis. Front Cardiovasc Med 2019;6:41. 
  11. Park JB, Avolio A. Arteriosclerosis and atherosclerosis assessment in clinical practice: methods and significance. Pulse (Basel) 2023;11:1-8. 
  12. Greve SV, Blicher MK, Kruger R, et al. Estimated carotid-femoral pulse wave velocity has similar predictive value as measured carotid-femoral pulse wave velocity. J Hypertens 2016;34:1279-1289. 
  13. Vianna CA, Horta BL, Gonzalez MC, Franca GVA, Gigante DP, Barros FL. Association of pulse wave velocity with body fat measures at 30 y of age. Nutrition 2019;61:38-42. 
  14. Yang H, Zhao J, Deng X, et al. Pulse wave velocity is decreased with obesity in an elderly Chinese population. J Clin Hypertens (Greenwich) 2019;21:1379-1385. 
  15. Cohen JB, Mitchell GF, Gill D, et al. Arterial stiffness and diabetes risk in Framingham Heart Study and UK Biobank. Circ Res 2022;131:545-554. 
  16. Zheng M, Zhang X, Chen S, et al. Arterial stiffness preceding diabetes: a longitudinal study. Circ Res 2020;127:1491-1498. 
  17. Agbaje AO, Barker AR, Mitchell GF, Tuomainen TP. Effect of arterial stiffness and carotid intima-media thickness progression on the risk of dysglycemia, insulin resistance, and dyslipidemia: a temporal causal longitudinal study. Hypertension 2022;79:667-678. 
  18. Kim Y, Han BG; KoGES group. Cohort profile: the Korean genome and epidemiology study (KoGES) consortium. Int J Epidemiol 2017;46:e20. 
  19. Kim BY, Kang SM, Kang JH, et al. 2020 Korean Society for the Study of Obesity Guidelines for the Management of Obesity in Korea. J Obes Metab Syndr 2021;30:81-92. 
  20. Reference Values for Arterial Stiffness' Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'. Eur Heart J 2010;31:2338-2350. 
  21. Xu X, Zeng J, Yang W, et al. Prevalence of metabolic syndrome among the adult population in western China and the association with socioeconomic and individual factors: four cross-sectional studies. BMJ Open 2022;12:e052457. 
  22. Moore JX, Chaudhary N, Akinyemiju T. Metabolic syndrome prevalence by race/ethnicity and sex in the United States, national health and nutrition examination survey, 1988-2012. Prev Chronic Dis 2017;14:E24. 
  23. Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review. BMC Public Health 2017;17:101. 
  24. Huh JH, Kang DR, Kim JY, Koh KK. Metabolic syndrome fact sheet 2021: executive report. Cardiometab Syndr J 2021;1:125-134. 
  25. Kim HJ, Kim BS, Lee Y, Ahn SB, Kim DW, Shin JH. Harnessing metabolic indices as a predictive tool for cardiovascular disease in a Korean population without known major cardiovascular event. Diabetes Metab J 2024 Feb 2 [Epub]. DOI: 10.4093/dmj.2023.0197. 
  26. Park JB, Sharman JE, Li Y, et al. Expert consensus on the clinical use of pulse wave velocity in Asia. Pulse (Basel) 2022;10:1-18. 
  27. Kim BS, Lee Y, Park JK, Lim YH, Shin JH. Association of the estimated pulse wave velocity with cardio-vascular disease outcomes among men and women aged 40-69 years in the Korean population: an 18-year follow-up report on the Ansung-Ansan cohort in the Korean genome environment study. J Pers Med 2022;12:1611. 
  28. Li D, Cao F, Cheng W, Xu Y, Yang C. Predictive value of estimated pulse wave velocity for cardiovascular and all-cause mortality in individuals with obesity. Diabetol Metab Syndr 2023;15:40. 
  29. Greve SV, Blicher MK, Kruger R, et al. Elevated estimated arterial age is associated with metabolic syndrome and low-grade inflammation. J Hypertens 2016;34:2410-2417. 
  30. Vlachopoulos C, Terentes-Printzios D, Laurent S, et al. Association of estimated pulse wave velocity with survival: a secondary analysis of SPRINT. JAMA Netw Open 2019;2:e1912831. 
  31. Huang H, Bu X, Pan H, et al. Estimated pulse wave velocity is associated with all-cause and cardio-cerebrovascular disease mortality in stroke population: Results from NHANES (2003-2014). Front Cardiovasc Med 2023;10:1140160. 
  32. Mancia G, Kreutz R, Brunstrom M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023;41:1874-2071. 
  33. Guzik TJ, Touyz RM. Oxidative stress, inflammation, and vascular aging in hypertension. Hypertension 2017;70:660-667. 
  34. van Bussel BC, Schouten F, Henry RM, et al. Endothelial dysfunction and low-grade inflammation are associated with greater arterial stiffness over a 6-year period. Hypertension 2011;58:588-595. 
  35. Dumor K, Shoemaker-Moyle M, Nistala R, Whaley-Connell A. Arterial stiffness in hypertension: an update. Curr Hypertens Rep 2018;20:72. 
  36. Rani V, Deep G, Singh RK, Palle K, Yadav UC. Oxidative stress and metabolic disorders: pathogenesis and therapeutic strategies Life Sci 2016;148:183-193. 
  37. Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006;444:860-867. 
  38. Starzak M, Stanek A, Jakubiak GK, Cholewka A, Cieslar G. Arterial stiffness assessment by pulse wave velocity in patients with metabolic syndrome and its components: is it a useful tool in clinical practice? Int J Environ Res Public Health 2022;19:10368. 
  39. Lee GP, Kim HL. Incremental value of the measures of arterial stiffness in cardiovascular risk assessment. Rev Cardiovasc Med 2022;23:6. 
  40. Sabio JM, Vargas-Hitos J, Zamora-Pasadas M, et al. Metabolic syndrome is associated with increased arterial stiffness and biomarkers of subclinical atherosclerosis in patients with systemic lupus erythematosus. J Rheumatol 2009;36:2204-2211. 
  41. Topouchian J, Labat C, Gautier S, et al. Effects of metabolic syndrome on arterial function in different age groups: the Advanced Approach to Arterial Stiffness study. J Hypertens 2018;36:824-833.