Background and aim: Metabolic syndrome (MetS) patients are at increased cardiovascular risk, but the exact mediation of the risk remains a matter of controversy. Various clusters of the metabolic syndrome components and other risk factors, such as advanced glycation end-products (AGE) and glycated hemoglobin (HbA1c), are considered, but large-scale studies are lacking. Therefore we aimed to investigate predictive value of MetS components and other factors on the arterial markers as a surrogate endpoint of cardiovascular risk.

Methods: A cross-sectional study of 3168 MetS subjects (aged 55±5, 69% women) was carried out by assessing various traditional and nontraditional cardiovascular risk factors and variety of arterial markers: intima media thickness (IMT), carotid, radial-femoral and aortic stiffness, ankle-brachial stiffness index (CAVI), endothelial function in brachial artery, finger and skin.

Results: The most common determinants of arterial markers by multiple linear and logistic regression analysis (p<0.05) were arterial hypertension (AH) and gender. Significant predictors of endothelial function in microcirculation predominantly were AH and glycemia-related parameters: AGE and HbA1c in finger, and fasting glucose in skin. In the brachial artery, endothelial function was predicted by age, AH and gender. Gender, AH, obesity markers, and glucose abnormalities were significant predictors of IMT and various arterial stiffness parameters. However, typical dyslipidemia remained a significant predictor of only 2 out of 14 arterial parameters assessed, namely, of IMT and CAVI.

Conclusion: Our study suggests that gender and hypertension, but not dyslipidemia, are the most common determinants of the variability of arterial parameters in subjects with MetS.