Carotid intima-media thickness and metabolic syndrome in a rural population: Results from the Baependi Heart Study

Background and aims: Carotid intima-media thickness (cIMT) is a strong predictor of cardiovascular events and associated with metabolic syndrome (MetS). MetS is a cluster of cardiovascular risk factors, but the association structure between specific factors and disease development is not well-established in rural populations. We described the association structure between MetS factors and cIMT in a sample from rural Brazil. Methods: We studied 1937 participants from the Baependi Heart Study who underwent carotid ultrasound exam. We used ATP-III-2001 for MetS definition and linear mixed-effects models, adjusting by the family structure, to assess independent associations between the cardiovascular risk factors which define MetS and cIMT. Results: The sample's mean age was 46 +/- 16y, 61% female, 73% white, mean body-mass-index 26 +/- 5 kg/m(2), mean cIMT 0.53 +/- 0.16 mm, with 35% of the sample classified with MetS. As expected, cIMT demonstrated a linear relationship with increasing age, and cIMT higher values were observed for MetS (0.58 +/- 0.16 mm) compared to non-MetS (0.49 +/- 0.14 mm). Considering models for cIMT with MetS and all of its factors, we found that blood pressure, glucose and obesity were independently associated with cIMT, but not HDL or triglycerides. Conclusions: cIMT showed a linear relationship with increasing age. Blood pressure, obesity, and glucose were independently associated with cIMT, but not HDL-cholesterol or triglycerides. In a rural population, hypertension, diabetes and obesity play a more important role than lipids in determining cIMT interindividual variability.