The Impact of Metabolic Syndrome, Homocysteine, and B Vitamins on Carotid Artery Intima-Media Thickness in Hypertensive Patients

作者：Liu Chung Pin; Lin Yu Li; Lin Yen Hung; Pao Kuan Yin; Wu Vin Cent; Su Ta Chen; Hung Chi Sheng; Gau Churn Shiouh; Hwang Juey Jen^*

来源：Acta Cardiologica Sinica, 2013, 29(1): 56-63.

• Folic acid
• Homocysteine
• Intima-media thickness
• Metabolic syndrome

Objectives: To examine the correlation between metabolic syndrome (MS), plasma total homocysteine (tHcy) level, and serum B vitamin levels on carotid intima-media thickness (CIMT) in hypertensive patients.
Methods: A total of 73 medically treated hypertensive patients (42 men, mean age 70.7 years), fasted for 10 hours, and provided fasting blood samples for measurement of plasma tHcy, serum folic acid, and serum vitamin B12 levels. Additionally, B-mode ultrasound of the distal right common carotid arteries was performed on all participants.
Results: There were 50 patients with and 23 patients without MS. Patients with MS had larger CIMT than patient without (0.81 +/- 0.13 vs. 0.74 +/- 0.10 mm, p = 0.018). Patients with MS had larger waist circumference (p < 0.001), higher body mass index (p < 0.001), elevated serum triglyceride level (p < 0.001), lower serum high density lipoprotein level (p = 0.016), higher prevalence of diabetes mellitus (p = 0.012), higher prevalence of hyperlipidemia (p = 0.019), and a higher prevalence of fibrate usage (p = 0.025) than patients without MS. In univariate analysis, CIMT correlated significantly with the presence of MS (r = 0.256; p = 0.029), usage of angiotensin receptor blocker (ARB; r = -0.256; p = 0.029), and male gender (r = 0.247; p = 0.035). The relationships between CIMT and serum folic acid level (r = -0.212; p = 0.072) or statin usage (r = 0.207; p = 0.079) were borderline significant. In multivariate regression analysis, after adjusting for age and gender, only usage of ARB (beta value -0.078, 95% CI: -0.140 to -0.015, p = 0.016) and the presence of MS (beta value 0.075, 95% CI: 0.020 to 0.131, p = 0.009) were associated with CIMT. In another model, after adjusting four additional parameters including age, gender, systolic blood pressure and usage of statin, usage of ARB (beta value -0.074, 95% CI: -0.137 to -0.011, p = 0.022) and presence of MS (beta value 0.069, 95% CI: 0.012 to 0.125, p = 0.017) remained significantly correlated with CIMT.
Conclusion: MS and usage of ARB are associated with CIMT in hypertensive patients.

• 出版日期2013-1