Gender Differences Of Metabolic Syndrome Group Fraction On The Internal Carotid Artery Thickness

Objective To explore the gender differences in effects of metabolic syndrome(MS) on the carotid intima-media thickness(IMT).Methods 593 cases in Health Examination Center of Northern Coal Group General Hospital were selected for the study. All subjects were accepted questionnaire survey, physical examination and biochemistry indices detection. Color doppler ultrasound were used to determine liver lipid contents and carotid IMT. According to any one of the standard MS diagnostic criteria as a group, subjects were divided into 0, 1, 2 or ≥3 groups. Subjects meeting <3 items were divided into non-MS group(NMS) and ≥3 items were divided into MS group. Female subjects less than and more than 1-year menopausal period were divided into premenopausal group and postmenopausal group, respectively. According to carotid IMT, subjects whose ≥0.9mm were divided into IMT thickening group and <0.9mm were divided into IMT non-thickening group. According to the frequency of smoking, smokers were divided into smoking group, occasionally somking group and non-smoking group. According to smoking index(SI), the number of cigarettes smoked per day by the number of years smoked, male subjects whose SI≤100, 100-200, 200-400 and ≥ 400 branch-year were divided into A, B, C and D group, respectively. SPSS19.0 software was used for statistical analysis. Student’s t test, nonparametric rank sum test, chi-square test, Fisher’s exact test, one-way ANOVA, multiple regression analysis and logistic regression analysis were adopted.Results 1.The detection rates of metabolic syndrome was 27.15%.The detection rate of male was 29.74%. The detection rate was 24.58% in female.Compared to the NMS group as control, the incidences of fatty liver disease(FLD) and thickening IMT were both significant increased in MS group, p<0.01. The incidence of carotid plaques in male, female, premenopausal and postmenopausal women of MS group were all raised than NMS group significantly, p<0.05. 2. The 0 group was chosen as the control. In male subjects, age, body mass index(BMI), waist circumference(WC), systolic blood pressure(SBP), diastolic blood pressure(DBP), serum uric acid(SUA), fasting plasma glucose(FBG), total cholesterol(TC), triglycerides(TG), low-density lipoprotein(LDL), the ratio of FLD, carotid IMT thickening ratio and smoking rate were gradually raised along with the increased items of MS diagnostic criteria, which had a significant difference among each groups, p<0.05. In each groups of MS, high-density lipoprotein(HDL) declined along with the increased items of MS, however there was no statistically significance, p>0.05. In female subjects, age, BMI, WC, SBP, DBP, SUA, FBG, TC, TG, HDL, LDL, the ratio of FLD, carotid IMT thickening ratio were gradually raised along with the increased items of MS diagnostic criteria, which had a significant difference among each groups, p<0.05. In each groups of MS, HDL declined along with the increased items of MS, there was statistically significance, p<0.05.3. The carotid IMT increased along with the increased metabolic syndrome components in male and female. Using paired-comparisons of different MS groups: male ≥3 group was significantly higher than other groups, p<0.05. There are significant differences between each groups of female, p<0.05. The same group grouping horizontal comparison, female carotid IMT value is higher than male in ≥3 group but lower in 0 and1 group, and there were significant difference in 1 group,p<0.05.Carotid IMT of postmenopausal women was higher than premenopausal in each grade. The differences in 0 group,1 group and ≥3 group between premenopausal and postmenopausal women were significant, p<0.05. 4.Multiple regression analysis showed that age, BMI, SUA, FBG, smoking affect carotid IMT independently in man. MS is not an independent risk factor of carotid IMT impact in man, p>0.05. Age, MS, smoking, FLD affect carotid IMT independently in women. MS is an independent risk factor of carotid IMT in women, p<0.01. Age, TG and LDL affect carotid IMT independently in premenopausal women. MS, age and smoking affect carotid IMT independently in postmenopausal women.5. According to smoking index(SI), the number of cigarettes smoked per day by the number of years smoked, male subjects whose SI ≤ 100, 100-200, 200-400 and ≥400 branch-year were divided into A, B, C and D group, respectively. After adjusting for factors including age, SUA, TC, LDL and BMI, compared with the A group, D group(OR value: 5.909; 95% CI: 1.673 ~ 20.877) had a significant difference, p<0.05. 6.Logistic regression analysis showed that after corrected age, smoking, SUA, TC, LDL and BMI, hyperlipidemia(OR: 5.410; 95% CI: 2.191 ~ 13.362) showed a significant correlation with thicken carotid IMT in men,p<0.05. Hyperlipidemia(OR: 4.319; 95%CI: 1.610 ~ 11.583), hypertension(OR: 6.389; 95% CI: 1.579 ~ 25.856) and hyperglycemia(OR: 10.033; 95% CI: 2.863 ~ 35.167) showed a significant correlation with thicken carotid IMT in women, p<0.05. MS is an independent risk factor for IMT thickening in women(OR value: 5.611; 95% CI: 1.398 ~ 22.632), however not in men(OR value: 1.091; 95%CI:(0.906 ~ 1.314).Conclusions The influence, correlation and independent risk factors of metabolic syndrome on carotid IMT thickening are different between men and women. Smoking involve in the occurrence and development of artery atherosclerosis in the process of MS. Smoking is associated with carotid IMT in men. The effects of MS on early carotid atherosclerosis in women are much more significant than men.