The Association of Metabolic Syndrome and Its Components with Electrocardiogram Parameters and Abnormalities Among an Iranian Rural Population: The Fasa PERSIAN Cohort Study

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Abstract

Background

Metabolic syndrome (MetS) as a set of cardiac risk factors and its growing prevalence is one of the major concerns in different societies. In this study, we aimed to investigate the relationship between Mets and electrocardiogram (ECG) parameters and abnormalities as indicators for subclinical cardiovascular diseases (CVD).

Methods

In this sub-analysis study, we used the data from Fasa PERSIAN Cohort Study which includes subjects age 35–70 years. Subjects with available ECG data included in the study (n=7002) and subjects with missing data on MetS components and non-sinus rhythm ECG were excluded (n=44). The MetS definition based on the Adult Treatment Panel (ATP) III guidelines and also a 12-lead ECG was obtained from all participants.

Results

Our study population (n=6958) showed a mean age of 48.60±9.34 years and also 1656 (24.2%) subjects had MetS. Except for P duration, PR interval and S amplitude in men and P amplitude, S amplitude, Sokolow-Lyon Index, and QT interval in women, other ECG parameters differ significantly between subjects with and without Mets (P<0.05). Also among ECG abnormalities, prolonged P duration (≥120ms), QRS duration (≥100ms), and QTc interval (>450ms in male, >470ms in female) had a significant association with MetS in the total population. Waist circumferences (WC) showed the most count of significant relationship with ECG parameters in both genders. In males, WC more than ATP cut-points had significant associations with prolonged P and QRS duration, and also blood pressure (BP) had significant associations with prolonged P and QRS durations and QTc interval. In females, the MetS component except triglyceride had at least a significant relationship with prolonged P and/or QRS duration.

Conclusion

MetS and its component especially WC and BP were associated with ECG parameters and abnormalities. These associations with ECG as a marker of subclinical CVD showed the importance of MetS and each component in our population to monitor in the further longitudinal studies.

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Most cited references 37

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Metabolic syndrome and risk of cardiovascular disease: a meta-analysis.

Andrea Galassi, Kristi Reynolds, Jiang Ping He (2006)

The use of different definitions of the metabolic syndrome has led to inconsistent results on the association between the metabolic syndrome and risk of cardiovascular disease. We examined the association between the metabolic syndrome and risk of cardiovascular disease. A MEDLINE search (1966-April 2005) was conducted to identify prospective studies that examined the association between the metabolic syndrome and risk of cardiovascular disease. Information on sample size, participant characteristics, metabolic syndrome definition, follow-up duration, and endpoint assessment was abstracted. Data from 21 studies met the inclusion criteria and were included. Individuals with the metabolic syndrome, compared to those without, had an increased mortality from all causes (relative risk [RR] 1.35; 95% confidence interval [CI], 1.17-1.56) and cardiovascular disease (RR 1.74; 95% CI, 1.29-2.35); as well as an increased incidence of cardiovascular disease (RR 1.53; 95% CI, 1.26-1.87), coronary heart disease (RR 1.52; 95% CI, 1.37-1.69) and stroke (RR 1.76; 95% CI, 1.37-2.25). The relative risk of cardiovascular disease associated with the metabolic syndrome was higher in women compared with men and higher in studies that used the World Health Organization definition compared with studies that used the Adult Treatment Panel III definition. This analysis strongly suggests that the metabolic syndrome is an important risk factor for cardiovascular disease incidence and mortality, as well as all-cause mortality. The detection, prevention, and treatment of the underlying risk factors of the metabolic syndrome should become an important approach for the reduction of the cardiovascular disease burden in the general population.

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Cardiac remodeling in obesity.

E. Dale Abel, Sheldon Litwin, Gary Sweeney (2008)

The dramatic increase in the prevalence of obesity and its strong association with cardiovascular disease have resulted in unprecedented interest in understanding the effects of obesity on the cardiovascular system. A consistent, but puzzling clinical observation is that obesity confers an increased susceptibility to the development of cardiac disease, while at the same time affording protection against subsequent mortality (termed the obesity paradox). In this review we focus on evidence available from human and animal model studies and summarize the ways in which obesity can influence structure and function of the heart. We also review current hypotheses regarding mechanisms linking obesity and various aspects of cardiac remodeling. There is currently great interest in the role of adipokines, factors secreted from adipose tissue, and their role in the numerous cardiovascular complications of obesity. Here we focus on the role of leptin and the emerging promise of adiponectin as a cardioprotective agent. The challenge of understanding the association between obesity and heart failure is complicated by the multifaceted interplay between various hemodynamic, metabolic, and other physiological factors that ultimately impact the myocardium. Furthermore, the end result of obesity-associated changes in the myocardial structure and function may vary at distinct stages in the progression of remodeling, may depend on the individual pathophysiology of heart failure, and may even remain undetected for decades before clinical manifestation. Here we summarize our current knowledge of this complex yet intriguing topic.

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Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study.

Fereidoun Azizi, Payam Salehi, Arash Etemadi … (2003)

The aim of the present investigation was to determine the prevalence of the metabolic syndrome among 103,68 of the adults (4,397 men and 5,971 women) aged 20 years and over, participating in the Tehran Lipid and Glucose Study. The metabolic syndrome was defined by the presence of three or more of the following components: abdominal obesity, hypertriglyceridemia, low HDL-C, high blood pressure, and high fasting glucose. The unadjusted prevalence of metabolic syndrome in the study population was 30.1% (CI 95%: 29.2-31.0) and age-standardized prevalence was 33.7% (CI 95%: 32.8-34.6). The prevalence increased with age in both sexes. The metabolic syndrome was more commonly seen in women than in men (42% vs. 24%, P<0.001). Low HDL-C was the most common metabolic abnormality in both sexes. Except for high FPG, all abnormalities were more common in women than in men (P<0.001). Most of those with metabolic syndrome had three components of the syndrome (58%), 33% had four, and 9% had five components. This report on the metabolic syndrome from Iran shows a high prevalence of this disorder. Efforts on promoting healthy diets, physical activity, and blood pressure control must be undertaken.

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Author and article information

Journal

Journal ID (nlm-ta): Diabetes Metab Syndr Obes

Journal ID (iso-abbrev): Diabetes Metab Syndr Obes

Journal ID (publisher-id): dmso

Journal ID (pmc): dmso

Title: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy

Publisher: Dove

ISSN (Electronic): 1178-7007

Publication date (Electronic): 24 August 2020

Publication date Collection: 2020

Volume: 13

Pages: 2975-2987

Affiliations

[1 ]Noncommunicable Diseases Research Center, Fasa University of Medical Sciences , Fasa, Iran

[2 ]Student Research Committee, Fasa University of Medical Sciences , Fasa, Iran

[3 ]National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences , Tehran, Iran

Author notes

Correspondence: Reza Homayounfar Noncommunicable Diseases Research Center, Fasa University of Medical Sciences , Fasa, IranTel +989125140840 Email r_homayounfar@yahoo.com

Author information

Mohammad Hosein Yazdanpanah http://orcid.org/0000-0003-3645-9430

Sayed Reza Hojati http://orcid.org/0000-0003-3498-3861

Reza Homayounfar http://orcid.org/0000-0001-5398-9519

Article

Publisher ID: 263093

DOI: 10.2147/DMSO.S263093

PMC ID: 7467662

PubMed ID: 32943893

SO-VID: f1e7a6c5-d0c0-411a-858d-42a74fecd27c

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 16 May 2020

Date accepted : 04 August 2020

Page count

Figures: 2, Tables: 13, References: 47, Pages: 13

Funding

Funded by: did not receive any specific funding;

The authors did not receive any specific funding in this study.

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The Association of Metabolic Syndrome and Its Components with Electrocardiogram Parameters and Abnormalities Among an Iranian Rural Population: The Fasa PERSIAN Cohort Study

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Abstract

Background

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Journal of the ASEAN Federation of Endocrine Societies

Most cited references 37

Metabolic syndrome and risk of cardiovascular disease: a meta-analysis.

Cardiac remodeling in obesity.

Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study.

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