- Email: [email protected]
SUBCLINICAL ATHEROSCLEROSIS (SA) AND METABOLIC SYNDROME (MS)
130
Poster Sessions PO28 Metabolic syndrome
increased. However, the parameters of cholesterol homeostasis for groups without or with one component of MS and values for groups with 4, 5 or 6 present MS components were similar. Conclusions: Individual components of MS are related both to the parameters of biosynthesis and absorption of cholesterol; the insulin level seems to be more important than glucose when describing the relationship of saccharide metabolism to MS. Developing insulin resistance does not exhibit expected relationship between the mechanisms of cholesterol biosynthesis and absorption. Support: Research project MSM 0021620820. PO28-461
PREVALENCE AND AWARENESS OF ABDOMINAL OBESITY IN TURKISH HEALTHCARE WORKERS
A. Oguz, G. Sagun, M. Uzunlulu, B. Alpaslan, E. Yorulmaz, E. Tekiner, A. Sariisik. Internal Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey Background and aims: The aim of present study was to evaluate the prevalence of abdominal obesity, to determine the level of awareness of the criteria for the diagnosis of abdominal obesity and metabolic syndrome (MetS), and to evaluate related lifestyle features in a sample of Turkish healthcare workers. Methods: A total of 723 healthcare workers (372 physicians, 247 nurses, 104 other healthcare staff; mean age, 32.83±8.18 years) from different institutions were included. Demographic, anthropometric, and biochemical data were recorded, and the lifestyle features were inquired. Adult Treatment Panel (ATP) III and International Diabetes Federation (IDF) definitions were used for abdominal obesity and MetS. Results: According to ATP III and IDF criteria, the prevalence of abdominal obesity were 13.8% (10.6% in women, 19.1% in men) and 32.4% (26% in women, 42.7% in men), respectively, and awareness of the cut-off values for abdominal obesity were 6.5% and 12.9%, respectively. Overall, 33.2% of participants were cognizant of MetS as a clinical syndrome, and the prevalence of MetS was 7.9%. Abdominal obesity was significantly associated with an age over 40, male gender, automobile driving, computer use ≥ 2 hours/day, and driving + television watching and/or computer use ≥ 2 hour/day. Conclusions: Prevalence of abdominal obesity was similar with general population for only male healthcare workers, but female healthcare workers had a lower frequency. Moreover, our results demonstrate that only a minority of healthcare workers were cognizant of MetS as a clinical syndrome and the definition of abdominal obesity. PO28-462
MS was an independent predictor for the presence of CP in normotensive subjects (odds ratio 2.38, 95% CI 1.19-4.76, p=0.014). This suggests that MS preferentially affects atherosclerotic process in the carotid artery to arterial stiffness in normotensive Korean subjects. PO28-463
CARDIOTROPHIN LEVELS IN PATIENTS WITH METABOLIC SYNDROME
O. Ari, L. Kolda¸s, S. ¸ Himmeto˘glu. Cardiology, Cerrahpa¸sa Faculty of Medicine, Istanbul, Turkey Background: Data about metabolic syndrome (MS) in Turkey was documented In METSAR and TEKHARF. Cardiotrophin-1 (CT) is an inflammatory cytokine. Relationship between Cardiovascular risk factors (CVRF)and inflammation was documented in previously. Objectives: There was little data about CT levels in MS. We aimed to compare CT levels in MS with normal control group. Methods: 100 patients (80 with MS)were included. Clinical and laboratory (blood tests, HOMA-IR index, echocardiography) evaluation were done. Heart failure, coronary synrdomes, and patients with LVH were excluded, because these conditions cause elevation in serum CT level. Blood was collected into EDTA tube, stored at -80 degree centigrade, ELISA technique was used. Statistical analysis: Mann Whitney U test. Results: Significant difference was present between MS and control group. (87.82±73.93 vs 3.91± 2.41;p < 0.0001). There was correlation between CT and fasting glucose, HOMA-IR index and HsCRP.
IMPACT OF THE METABOLIC SYNDROME ON ARTERIAL STIFFNESS AND CAROTID ULTRASOUND TRAITS IS DIFFERENT BETWEEN HYPERTENSIVE AND NORMOTENSIVE KOREANS
Y.K. Kim, Y. Kim, S.H. Na, M.Y. Rhee, M.M. Lee. Cardiovascular Center, Dongguk University International Hospital, Goyang, Gyeonggi-Do, South Korea The metabolic syndrome (MS) is associated with increased cardiovascular risk in general population and hypertensive patients. However, little is known whether functional and structural arterial changes are differently affected by MS in subjects with or without hypertension. 270 hypertensive and 344 normotensive subjects were enrolled. None had diabetes, renal disease, and pharmacological treatment of hypertension or dyslipidemia. All subjects underwent heart-femoral (hf) and brachialankle (ba) pulse wave velocity (PWV) determination by means of an automatic wave form analyzer and carotid ultrasound examination for measurement of intima-media thickness (C-IMT) and detection of plaque (CP). Hypertensive patients with and without MS did not significantly differ by age, sex distribution, SBP, DBP, hfPWV, baPWV, C-IMT, and the presence of CP. Normotensive subjects with and without MS did not significantly differ by age and sex distribution. Although subjects with MS had significantly higher SBP and DBP compared with those without MS, hfPWV and baPWV were not different. However, C-IMT was significantly higher in subjects with MS compared with those without MS (0.70±0.12 vs 0.65±0.09 mm, p=0.006). This difference held after controlling for age, sex, BMI, SBP, glucose, total cholesterol, HDL-cholesterol, and triglyceride (p=0.047). The presence of CP was also significantly higher in subjects with MS (32.7 vs 16.6%, p=0.005). A logistic regression analysis revealed that
Conclusion: Difference was correlated with other CVRF.So, plasma CT can be used as a marker of CVRF in patients with MS. PO28-464
SUBCLINICAL ATHEROSCLEROSIS (SA) AND METABOLIC SYNDROME (MS)
I. Colina, J.M. Araquistain, I. Alberola, O. Beloqui. 1 Internal Medicine, University Clinic, University of Navarra, Spain MS is associated with increased cardiovascular risk. Carotid intima-media thickness (CIMT) is a validated method for detecting SA. We investigated the prevalence of SA in patients with MS and the influence of the individual MS components on the occurrence of SA. Methods: We studied 1186 consecutive patients from our outpatient clinic. MS was defined according to the NECP-III criteria. CIMT (ultrasonography) was measured in both common carotid arteries (abnormal value > 0.80 mm). Results: Among our 1186 patients, 387 had MS. The remaining 799 constituted the non-MS group. CIMT in patients with MS (0.77+ 0.009)
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO28 Metabolic syndrome was significantly higher than in non-MS cases (0.71 + 0.006, p=0.000). The occurrence of MS implies a 3-fold risk of abnormal CIMT. The presence of only one component of MS significantly increased the risk of an abnormal CIMT. In fact, there is a significant linear correlation between the number of MS components and the presence of a pathologic CIMT (p for trend 0.003). An univariate analysis demonstrated that, with the exception of hypertriglyceridemia, all the components of MS were associated significantly with an increased CIMT. Finally, a multivariate analysis showed that abdominal obesity (OR: 1.32; CI 0.99 – 1.76; p= 0.05) and arterial hypertension (OR: 2.22; CI: 1.45-2.75; p<0.000) were the components of MS with a significant association with increased CIMT. Conclusions: MS is significantly associated with pathological CIMT, a surrogate marker of SA. An early detection of vascular damage is of crucial importance for a more aggresive and earlier treatment of MS components. PO28-465
FASTING PLASMA GHRELIN LEVELS ARE INVERSELY ASSOCIATED WITH THE METABOLIC SYNDOROME AND PAI-1 IN A GENERAL POPULATION
Objective: Plasma ghrelin is a novel gastric peptide identified in 1999 as a "hunger hormone”. The aim of this study was to investigate the relationship between ghrelin levels and the metabolic syndrome (MS) and PAI-1 in the general population. Methods: Ghrelin levels were measured by ELISA in 656 Japanese (244 men and 412 women) aged over 40 years received a population-based health examination between 2005 and 2007. We defined the MS by the Japanese criteria: (Abdominal obesity; given as waist circumference (>85cm in men and 90cm in women) as proposed by the Japanese Society for the Obesity, triglycerides (≥150mg/dl), HDL-cholesterol (<40mg/dl): blood pressure (≥130/ ≥85mmHg) and fasting plasma glucose (≥110mg/dl). Results: Mean ghrelin level was 158.7fmol/ml (131.0fmol/ml in men, 175.2fmol/ml in women, respectively). Ghrelin decreased with age (p=0.01). The prevalence of the MS was 10.8%. Ghrelin levels were decreased (p<0.001 for trend) in proportion to the accumulation of the number of the component of the MS adjusted for age and sex. A significant inverse association (p=0.002 for trend) was shown between ghrelin and quartiles of PAI-1 levels adjusted for age and sex. Conclusions: The results may suggest that the MS is associated with low ghrelin levels suggesting a relation to visceral fat accumulation and PAI-1 concentrations. PO28-466
CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH CHRONIC RENAL FAILURE AND METABOLIC SYNDROME
T. Bozek 1 , K. Peros 1 , I. Prkacin 2 , S. Jankovic 2 . 1 Diabetology Department, University Clinic, Vuk Vrhovac, Zagreb, Croatia; 2 Department of Internal Medicine, Clinical Hospital Merkur, Zagreb, Croatia Background and aims: Metabolic syndrome (MS) refers to a cluster of metabolic disorders related to insulin resistance. MS is associated with increased risk of cardiovascular disease. Renal function abnormalities are related to enhanced cardiovascular risk, considered to be due to the presence of associated risk factors. Methods: 129 hypertensive patients (66 male, 63 female, mean age 69,8±12,1 yrs) with chronic renal failure (CRF) were enrolled in the study. Complete clinical data were collected (weight, height, waist circumference, BP). Blood sample and 24-h urin collection were obtained to meassure serum values of creatinine, glucose, total cholesterol, HDL and LDL cholesterol, tryglycerides, hsCRP, serum uric acid, sodium, potassium, creatinin clearance (CC) and microalbuminuria. Cardiac ultrasonography was performed to asses wall thicknes of the left ventricle. According to the CC (60-90;30-60;15-30;<15 ml/min per 1,73m2 ) patients were assigned to four stages of CRF. Results: Left ventricle hypertrophy (LVH) was detected in 93,1% of patients with MS while in group without MS in 56,9%. In group of patients with MS significantly higher level of hsCRP (8,31±2,86 vs. 5,38±1,63, p<0,01) and serum uric acid (567±155,16 vs. 367,23±76,44, p<0,01) was found compared to the group without MS.
A differense in uric acid and hsCRP was observed according to the stage of CRF, but not significant. Conclusions: Our results suggest significant prevalence of LVH in CRF patients. Combination of diet regimen, weight reduction, usage of antihypertensive and uricostatic drugs, folic acid, statins as well as increased physical activity should be considered in patients with MS and CRF. PO28-467
LOW URINE PH IN PATIENTS WITH CHRONIC KIDNEY DISEASE (STAGE I-IV) AND METABOLIC SYNDROME WITHOUT KIDNEY STONE DISEASE
A. Karakas 1 , T. Bozek 1 , I. Mandac 2 , K. Peros 1 , I. Prkacin 2 . 1 Diabetology Department, University Clinic, Vuk Vrhovac, Zagreb, Croatia; 2 Department of Internal Medicine, Clinical Hospital Merkur, Zagreb, Croatia Background: Association between metabolic syndrome and alterations in renal function is well known. Patients with kidney stone disease and metabolic syndrome have acidic urine. The aim of this study was to examine wheather there is any connection between the metabolic syndrome and urine pH in patients with chronic kidney disease (CKD) without a history of nephrolithiasis. Methods: 65 patients with CKD (36 male, 29 female, mean age 66,5±14,1 yrs) were enrolled in the study. Study duration was 6 months. Complete clinical data were collected (weight, height, waist circumference, BP). Blood sample and 24-h urin collection were obtained to meassure serum values of complete blood count, creatinine, glucose, total cholesterol, HDL and LDL cholesterol, tryglycerides, hsCRP, serum uric acid, sodium, potassium, creatinin clearance (CC) and microalbuminuria. Urine pH was measured by pH electrode. According to the CC value (60-90;30-60;15-30;<15 ml/min per 1,73m2 ) patients were assigned to four stages of CKD. Results: In group of patients with CKD and MS urine pH level was significantly lower compared to the group of patients with CKD and without MS, on the beginning (5,45±0,54 vs. 6,90±0,53, p<0,001) and on the end (5,37±0,48 vs. 6,92±0,54, p<0,001) of the study. No difference was observed between stage of chronic kidney disease and value of urin pH. Conclusion: Acidic urine is a feature of CKD patients (stage I –IV) with metabolic syndrome. PO28-468
THE PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
E. Vlachogiannis, O. Nikitidou, A. Dougalis, C. Liavas, A. Vasileiou, E. Dascalopoulou. Dept of Internal Medicine, St Paul General Hospital, Thessaloniki, Greece Background: Obstructive Sleep Apnea Syndrome (OSAS) is a causative factor of cardiovascular disease (CVD) and is implicated in the pathogenesis of hypertension, disturbances of glucose metabolism and dyslipidemia. Aims and objectives: The purpose of this study was to estimate the prevalence of metabolic syndrome (MetS) in patients with OSAS. Methods: A total of 1222 patients (949 men and 273 women) with a positive questionnaire for sleep apnea (Group A) were studied for MetS according to Adult Panel III (ATPIII) of National Cholesterol Education Program (NCEP) criteria. After polysomnography study, 1138 patients (889 men and 249 women) was found to suffer from OSAS (Group B-1) while 78 (55 men and 23 women) did not meet the polysomnographic criteria of OSAS (Group B-2). In each Group, MetS was estimated according to clinical examination (MetS-1), biochemical results (MetS-2) and after the 24hour ambulatory measurements (MetS-3). Results: Group A: MetS-1 was diagnosed in 21.9%, MetS-2 in 42.9% and MetS-3 in 58.8% patients. Group B-1: the prevalence of MetS-1 was 22.9%, MetS-2 44.8% and MetS-3 60.7%. Group B-2: the prevalence of MetS-1, MetS-2 and MetS-3 was 9%, 17.9% and 24.3% respectively. The prevalence of MetS-1, MetS-2 and MetS-3 was statistically significantly higher in Group B-1, compared to Group B-2(p<0.0001).In both groups the prevalence of MetS-3 was statistically significantly higher (p<0.0001) than the prevalence of MetS-1 and MetS-2 Conclusions: Our data demonstrate that in patients with OSAS the prevalence of MetS, was significantly higher than the prevalence after estimation of NCEP/ATP III criteria alone.
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
POSTER SESSIONS
Y. Nanjo, H. Adachi, K. Furuki, S. Kumagae, M. Otsuka, A. Fukami, A. Satoh, M. Enomoto, T. Imaizumi. Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
131
Poster Sessions PO28 Metabolic syndrome
increased. However, the parameters of cholesterol homeostasis for groups without or with one component of MS and values for groups with 4, 5 or 6 present MS components were similar. Conclusions: Individual components of MS are related both to the parameters of biosynthesis and absorption of cholesterol; the insulin level seems to be more important than glucose when describing the relationship of saccharide metabolism to MS. Developing insulin resistance does not exhibit expected relationship between the mechanisms of cholesterol biosynthesis and absorption. Support: Research project MSM 0021620820. PO28-461
PREVALENCE AND AWARENESS OF ABDOMINAL OBESITY IN TURKISH HEALTHCARE WORKERS
A. Oguz, G. Sagun, M. Uzunlulu, B. Alpaslan, E. Yorulmaz, E. Tekiner, A. Sariisik. Internal Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey Background and aims: The aim of present study was to evaluate the prevalence of abdominal obesity, to determine the level of awareness of the criteria for the diagnosis of abdominal obesity and metabolic syndrome (MetS), and to evaluate related lifestyle features in a sample of Turkish healthcare workers. Methods: A total of 723 healthcare workers (372 physicians, 247 nurses, 104 other healthcare staff; mean age, 32.83±8.18 years) from different institutions were included. Demographic, anthropometric, and biochemical data were recorded, and the lifestyle features were inquired. Adult Treatment Panel (ATP) III and International Diabetes Federation (IDF) definitions were used for abdominal obesity and MetS. Results: According to ATP III and IDF criteria, the prevalence of abdominal obesity were 13.8% (10.6% in women, 19.1% in men) and 32.4% (26% in women, 42.7% in men), respectively, and awareness of the cut-off values for abdominal obesity were 6.5% and 12.9%, respectively. Overall, 33.2% of participants were cognizant of MetS as a clinical syndrome, and the prevalence of MetS was 7.9%. Abdominal obesity was significantly associated with an age over 40, male gender, automobile driving, computer use ≥ 2 hours/day, and driving + television watching and/or computer use ≥ 2 hour/day. Conclusions: Prevalence of abdominal obesity was similar with general population for only male healthcare workers, but female healthcare workers had a lower frequency. Moreover, our results demonstrate that only a minority of healthcare workers were cognizant of MetS as a clinical syndrome and the definition of abdominal obesity. PO28-462
MS was an independent predictor for the presence of CP in normotensive subjects (odds ratio 2.38, 95% CI 1.19-4.76, p=0.014). This suggests that MS preferentially affects atherosclerotic process in the carotid artery to arterial stiffness in normotensive Korean subjects. PO28-463
CARDIOTROPHIN LEVELS IN PATIENTS WITH METABOLIC SYNDROME
O. Ari, L. Kolda¸s, S. ¸ Himmeto˘glu. Cardiology, Cerrahpa¸sa Faculty of Medicine, Istanbul, Turkey Background: Data about metabolic syndrome (MS) in Turkey was documented In METSAR and TEKHARF. Cardiotrophin-1 (CT) is an inflammatory cytokine. Relationship between Cardiovascular risk factors (CVRF)and inflammation was documented in previously. Objectives: There was little data about CT levels in MS. We aimed to compare CT levels in MS with normal control group. Methods: 100 patients (80 with MS)were included. Clinical and laboratory (blood tests, HOMA-IR index, echocardiography) evaluation were done. Heart failure, coronary synrdomes, and patients with LVH were excluded, because these conditions cause elevation in serum CT level. Blood was collected into EDTA tube, stored at -80 degree centigrade, ELISA technique was used. Statistical analysis: Mann Whitney U test. Results: Significant difference was present between MS and control group. (87.82±73.93 vs 3.91± 2.41;p < 0.0001). There was correlation between CT and fasting glucose, HOMA-IR index and HsCRP.
IMPACT OF THE METABOLIC SYNDROME ON ARTERIAL STIFFNESS AND CAROTID ULTRASOUND TRAITS IS DIFFERENT BETWEEN HYPERTENSIVE AND NORMOTENSIVE KOREANS
Y.K. Kim, Y. Kim, S.H. Na, M.Y. Rhee, M.M. Lee. Cardiovascular Center, Dongguk University International Hospital, Goyang, Gyeonggi-Do, South Korea The metabolic syndrome (MS) is associated with increased cardiovascular risk in general population and hypertensive patients. However, little is known whether functional and structural arterial changes are differently affected by MS in subjects with or without hypertension. 270 hypertensive and 344 normotensive subjects were enrolled. None had diabetes, renal disease, and pharmacological treatment of hypertension or dyslipidemia. All subjects underwent heart-femoral (hf) and brachialankle (ba) pulse wave velocity (PWV) determination by means of an automatic wave form analyzer and carotid ultrasound examination for measurement of intima-media thickness (C-IMT) and detection of plaque (CP). Hypertensive patients with and without MS did not significantly differ by age, sex distribution, SBP, DBP, hfPWV, baPWV, C-IMT, and the presence of CP. Normotensive subjects with and without MS did not significantly differ by age and sex distribution. Although subjects with MS had significantly higher SBP and DBP compared with those without MS, hfPWV and baPWV were not different. However, C-IMT was significantly higher in subjects with MS compared with those without MS (0.70±0.12 vs 0.65±0.09 mm, p=0.006). This difference held after controlling for age, sex, BMI, SBP, glucose, total cholesterol, HDL-cholesterol, and triglyceride (p=0.047). The presence of CP was also significantly higher in subjects with MS (32.7 vs 16.6%, p=0.005). A logistic regression analysis revealed that
Conclusion: Difference was correlated with other CVRF.So, plasma CT can be used as a marker of CVRF in patients with MS. PO28-464
SUBCLINICAL ATHEROSCLEROSIS (SA) AND METABOLIC SYNDROME (MS)
I. Colina, J.M. Araquistain, I. Alberola, O. Beloqui. 1 Internal Medicine, University Clinic, University of Navarra, Spain MS is associated with increased cardiovascular risk. Carotid intima-media thickness (CIMT) is a validated method for detecting SA. We investigated the prevalence of SA in patients with MS and the influence of the individual MS components on the occurrence of SA. Methods: We studied 1186 consecutive patients from our outpatient clinic. MS was defined according to the NECP-III criteria. CIMT (ultrasonography) was measured in both common carotid arteries (abnormal value > 0.80 mm). Results: Among our 1186 patients, 387 had MS. The remaining 799 constituted the non-MS group. CIMT in patients with MS (0.77+ 0.009)
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
Poster Sessions PO28 Metabolic syndrome was significantly higher than in non-MS cases (0.71 + 0.006, p=0.000). The occurrence of MS implies a 3-fold risk of abnormal CIMT. The presence of only one component of MS significantly increased the risk of an abnormal CIMT. In fact, there is a significant linear correlation between the number of MS components and the presence of a pathologic CIMT (p for trend 0.003). An univariate analysis demonstrated that, with the exception of hypertriglyceridemia, all the components of MS were associated significantly with an increased CIMT. Finally, a multivariate analysis showed that abdominal obesity (OR: 1.32; CI 0.99 – 1.76; p= 0.05) and arterial hypertension (OR: 2.22; CI: 1.45-2.75; p<0.000) were the components of MS with a significant association with increased CIMT. Conclusions: MS is significantly associated with pathological CIMT, a surrogate marker of SA. An early detection of vascular damage is of crucial importance for a more aggresive and earlier treatment of MS components. PO28-465
FASTING PLASMA GHRELIN LEVELS ARE INVERSELY ASSOCIATED WITH THE METABOLIC SYNDOROME AND PAI-1 IN A GENERAL POPULATION
Objective: Plasma ghrelin is a novel gastric peptide identified in 1999 as a "hunger hormone”. The aim of this study was to investigate the relationship between ghrelin levels and the metabolic syndrome (MS) and PAI-1 in the general population. Methods: Ghrelin levels were measured by ELISA in 656 Japanese (244 men and 412 women) aged over 40 years received a population-based health examination between 2005 and 2007. We defined the MS by the Japanese criteria: (Abdominal obesity; given as waist circumference (>85cm in men and 90cm in women) as proposed by the Japanese Society for the Obesity, triglycerides (≥150mg/dl), HDL-cholesterol (<40mg/dl): blood pressure (≥130/ ≥85mmHg) and fasting plasma glucose (≥110mg/dl). Results: Mean ghrelin level was 158.7fmol/ml (131.0fmol/ml in men, 175.2fmol/ml in women, respectively). Ghrelin decreased with age (p=0.01). The prevalence of the MS was 10.8%. Ghrelin levels were decreased (p<0.001 for trend) in proportion to the accumulation of the number of the component of the MS adjusted for age and sex. A significant inverse association (p=0.002 for trend) was shown between ghrelin and quartiles of PAI-1 levels adjusted for age and sex. Conclusions: The results may suggest that the MS is associated with low ghrelin levels suggesting a relation to visceral fat accumulation and PAI-1 concentrations. PO28-466
CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH CHRONIC RENAL FAILURE AND METABOLIC SYNDROME
T. Bozek 1 , K. Peros 1 , I. Prkacin 2 , S. Jankovic 2 . 1 Diabetology Department, University Clinic, Vuk Vrhovac, Zagreb, Croatia; 2 Department of Internal Medicine, Clinical Hospital Merkur, Zagreb, Croatia Background and aims: Metabolic syndrome (MS) refers to a cluster of metabolic disorders related to insulin resistance. MS is associated with increased risk of cardiovascular disease. Renal function abnormalities are related to enhanced cardiovascular risk, considered to be due to the presence of associated risk factors. Methods: 129 hypertensive patients (66 male, 63 female, mean age 69,8±12,1 yrs) with chronic renal failure (CRF) were enrolled in the study. Complete clinical data were collected (weight, height, waist circumference, BP). Blood sample and 24-h urin collection were obtained to meassure serum values of creatinine, glucose, total cholesterol, HDL and LDL cholesterol, tryglycerides, hsCRP, serum uric acid, sodium, potassium, creatinin clearance (CC) and microalbuminuria. Cardiac ultrasonography was performed to asses wall thicknes of the left ventricle. According to the CC (60-90;30-60;15-30;<15 ml/min per 1,73m2 ) patients were assigned to four stages of CRF. Results: Left ventricle hypertrophy (LVH) was detected in 93,1% of patients with MS while in group without MS in 56,9%. In group of patients with MS significantly higher level of hsCRP (8,31±2,86 vs. 5,38±1,63, p<0,01) and serum uric acid (567±155,16 vs. 367,23±76,44, p<0,01) was found compared to the group without MS.
A differense in uric acid and hsCRP was observed according to the stage of CRF, but not significant. Conclusions: Our results suggest significant prevalence of LVH in CRF patients. Combination of diet regimen, weight reduction, usage of antihypertensive and uricostatic drugs, folic acid, statins as well as increased physical activity should be considered in patients with MS and CRF. PO28-467
LOW URINE PH IN PATIENTS WITH CHRONIC KIDNEY DISEASE (STAGE I-IV) AND METABOLIC SYNDROME WITHOUT KIDNEY STONE DISEASE
A. Karakas 1 , T. Bozek 1 , I. Mandac 2 , K. Peros 1 , I. Prkacin 2 . 1 Diabetology Department, University Clinic, Vuk Vrhovac, Zagreb, Croatia; 2 Department of Internal Medicine, Clinical Hospital Merkur, Zagreb, Croatia Background: Association between metabolic syndrome and alterations in renal function is well known. Patients with kidney stone disease and metabolic syndrome have acidic urine. The aim of this study was to examine wheather there is any connection between the metabolic syndrome and urine pH in patients with chronic kidney disease (CKD) without a history of nephrolithiasis. Methods: 65 patients with CKD (36 male, 29 female, mean age 66,5±14,1 yrs) were enrolled in the study. Study duration was 6 months. Complete clinical data were collected (weight, height, waist circumference, BP). Blood sample and 24-h urin collection were obtained to meassure serum values of complete blood count, creatinine, glucose, total cholesterol, HDL and LDL cholesterol, tryglycerides, hsCRP, serum uric acid, sodium, potassium, creatinin clearance (CC) and microalbuminuria. Urine pH was measured by pH electrode. According to the CC value (60-90;30-60;15-30;<15 ml/min per 1,73m2 ) patients were assigned to four stages of CKD. Results: In group of patients with CKD and MS urine pH level was significantly lower compared to the group of patients with CKD and without MS, on the beginning (5,45±0,54 vs. 6,90±0,53, p<0,001) and on the end (5,37±0,48 vs. 6,92±0,54, p<0,001) of the study. No difference was observed between stage of chronic kidney disease and value of urin pH. Conclusion: Acidic urine is a feature of CKD patients (stage I –IV) with metabolic syndrome. PO28-468
THE PREVALENCE OF METABOLIC SYNDROME IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME
E. Vlachogiannis, O. Nikitidou, A. Dougalis, C. Liavas, A. Vasileiou, E. Dascalopoulou. Dept of Internal Medicine, St Paul General Hospital, Thessaloniki, Greece Background: Obstructive Sleep Apnea Syndrome (OSAS) is a causative factor of cardiovascular disease (CVD) and is implicated in the pathogenesis of hypertension, disturbances of glucose metabolism and dyslipidemia. Aims and objectives: The purpose of this study was to estimate the prevalence of metabolic syndrome (MetS) in patients with OSAS. Methods: A total of 1222 patients (949 men and 273 women) with a positive questionnaire for sleep apnea (Group A) were studied for MetS according to Adult Panel III (ATPIII) of National Cholesterol Education Program (NCEP) criteria. After polysomnography study, 1138 patients (889 men and 249 women) was found to suffer from OSAS (Group B-1) while 78 (55 men and 23 women) did not meet the polysomnographic criteria of OSAS (Group B-2). In each Group, MetS was estimated according to clinical examination (MetS-1), biochemical results (MetS-2) and after the 24hour ambulatory measurements (MetS-3). Results: Group A: MetS-1 was diagnosed in 21.9%, MetS-2 in 42.9% and MetS-3 in 58.8% patients. Group B-1: the prevalence of MetS-1 was 22.9%, MetS-2 44.8% and MetS-3 60.7%. Group B-2: the prevalence of MetS-1, MetS-2 and MetS-3 was 9%, 17.9% and 24.3% respectively. The prevalence of MetS-1, MetS-2 and MetS-3 was statistically significantly higher in Group B-1, compared to Group B-2(p<0.0001).In both groups the prevalence of MetS-3 was statistically significantly higher (p<0.0001) than the prevalence of MetS-1 and MetS-2 Conclusions: Our data demonstrate that in patients with OSAS the prevalence of MetS, was significantly higher than the prevalence after estimation of NCEP/ATP III criteria alone.
77th Congress of the European Atherosclerosis Society, April 26–29, 2008, Istanbul, Turkey
POSTER SESSIONS
Y. Nanjo, H. Adachi, K. Furuki, S. Kumagae, M. Otsuka, A. Fukami, A. Satoh, M. Enomoto, T. Imaizumi. Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine
131