Subclinical target organ damage in mentally working employees: what is the key factor — metabolic syndrome as a cluster or its components?

Objective. To estimate the association between metabolic syndrome (MS) and its components with markers of subclinical target organ damage (TOD) in otherwise healthy bank employees.

Design and methods. A sample of 383 participants with at least 1 component of MS and without cardiovascular complications was randomly selected from a cohort of bank employees (n = 1600). Mean age of participants was 46,6 ± 9,0 years, 66,3 % were females (n = 254). Anthropometry, fasting lipids, creatinine (estimated glomerular filtration rate calculation, eGFR), and fasting glucose were performed according to standard procedures. In all patients echocardiography (left ventricular myocardial mass index assessment, LVMMI), carotid ultrasound (atherosclerotic plaques and intima-media thickness evaluation, IMT), arterial stiffness (pulse wave velocity measurement, PWV), ankle-brachial index, and urine albumin were assessed.

Results. Patients with MS (n = 229; 50,9 %) had significantly higher prevalence of atherosclerotic plaques (n = 29; 12,7 % vs. n = 9; 5,7 %; p = 0,03) and low eGFR (81,3 ± 13,1 vs. 84,3 ± 13,7 ml/min/m 3; р = 0,03) compared to patients without MS. All markers of subclinical TOD were associated with age based on multiple linear regression. Blood pressure correlated with LVMMI and
PWV, hypercholesterolemia — with increased IMT, hypertriglyceridemia — with PWV, and LVMMI — with waist circumference. There was no association between MS and TOD markers.

Conclusions. Left ventricular hypertrophy was detected more often in females (probably due to higher prevalence of abdominal obesity), while carotid atherosclerotic lesions were more frequently found in males (possibly due to higher prevalence of hypertriglyceridemia). TOD was more profound with the higher number of MS components, in particular, atherosclerotic plaques and decreased eGFR. Individual components of MS (hypertension, obesity, dyslipidemia) and age were the main factors associated with structural changes of cardiovascular system, but no effect was
found for MS as a cluster.

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