| Many clinical studies have shown that cluster of risk factors such as type 2 diabetes mellitus, impaired glucose tolerance, hypertension, disorder of lipid and central obesity often assembled with the same patient. This was identified as metabolic syndrome (MS) by WHO in 1999. The prevalence of MS and its complication of cardiovascular and periphery conduit vessels have been incredibly increasing in the past decades. For this reason, it is important in clinic to prevent and management the atherosclerosis(AS). The ultrasound techniques has been extensively used to detect the vascular lesion, especially to probe the AS. It was a quick,safe and woundless examining method. The ultrasonic diagnosis of the structure and function of the carotid can detect the AS of the periphery conduit vessels. Every composition of MS could lead to the AS, and the cluster of many risk factors would be more susceptible to the AS. Recently the change of the carotid AS in hypertensive and type 2 diabetes were observed, but rarely reported in patients with MS . This study aims to investigate the characteristics of the structure and function of the carotid artery in the MS subjects and provide some valuable suggestion to prevent damage of the conduit vessels in MS.Subjects and Methods:1. Subjects Four hundred and thirty five patients aged 30-86 years old (male 247, and female 188) were divided into three groups. 1) diabetes mellitus (DM,106); 2) essential hypertension (EH,118); 3) metabolic syndrome(MS,211). The MS definition was suggested by a working group consulted by the WHO in 1999 (glucose intolerance or insulin resistance or diabetes together with 2 or more the following risk factors: BP≥140/90 mmHg; TG>1.7, and/or HDL-C < 0.9 mmol/L; central body obesity and/or BMI ≥25kg/m2; microalbuminuria). 2. Methods All patients were collected venous blood to assay fasting glucose, fasting insulin, fasting total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB),uric acid(UA) and free fatty acid(FFA). Urinary albumin excretion (UAE) were detected. All patients were observed by Color Doppler ultrasonography. The inner diameter of the common carotid artery(CCA) , the intima-media thickness(IMT) of the CCA and the blood flow rate of CCA, internal carotid artery(ICA), external carotid artery(ECA) were measured, then calculated resistent index,plaque index and incidence rate of plaque. Results:1. The illness duration and age were significantly higher in MS compared with DM and EH(P<0.01, P<0.01). The level of TG,the ratio of TG/HDL-C and the index of HOMA-IR were significantly higher in MS compared with DM and EH(P<0.05 or P<0.01).2. The incidence rate of plaque was significantly higher when CCA-IMT≥0.8mm(P<0.05), and the plaque indices was significantly increased when CCA-IMT≥1.0mm(P<0.01).3. Compared with DM and EH, the RI-CCA,CCA-IMT,plaque indicies and incidence rate of plaque were significantly higher in MS(P<0.01, P<0.05, P<0.01, P<0.01).4. UAE was significantly linear correlated with IMT. The CCA-IMT,inner diameter of CCA,incidence rate of plaque were significantly higher in abnormal MAU group (≥30 mg/ 24h) compared with normal MAU group(P<0.01,P<0.01,P<0.05). The incidence rate of plaque was significantly higher when UAE≥60mg/24h(P<0.05).5. The stratified analysis confirms that the incidence rate of plaque was significantly higher in abnormal MAU group compared with normal MAU group with EH(P<0.05). The CCA-IMT and inner diameter of CCA were significantly higher in abnormal MAU group compared with normal MAU group with MS(P<0.05,P<0.05).Conclusions: 1. Compared with DM and EH, the MS patients had more severe insulin resistance.2. IMT was closely related to the occurence of AS. It indicated that the incidence of AS would be increasing gradually when CCA-IMT≥0.8mm. However, AS were significantly increased when CCA-IMT≥1.0mm. 3. Compared with DM and EH subjects, patients with MS suffered from mo...
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