P8.02 IMPACT OF TRIGLYCERIDES AND INSULIN LEVELS ON WHOLE AND SURFACE CAROTID PLAQUE COMPOSITION IN PATIENTS WITH METABOLIC SYNDROME

Abstract

Introduction: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities strongly associated with atherosclerosis and increased risk of CV events. Atherosclerotic plaques (AP) and its echolucency (ECL) can be detected using ultrasound (US) and evaluated by grey scale median analysis (GSM). ECL is associated with a higher plaque lipid content and vulnerability to rupture. Aim: To assess the association between carotid plaques ECL and plasma markers of vascular inflammation, and disarray of lipid and glucose metabolism in patients (p.) with MetS. Methods: After evaluating plasma lipids, glucose and insulin levels, blood pressure, and waist circumference in 700p., 390 (56%) presented MetS (ATP III). Carotid US evaluation revealed AP in 185 (47%) of them (age 54.2±11.1, 33.3% females). AP were evaluated by GSM analysis, and divided in tertiles of ECL of the whole AP (whole plaque GSM, WGSM) and for the luminal first millimeter of the plaque (surface GSM, SGSM). The relation between tertiles of WGSM and SGSM and plasma lipids, glucose, insulin, CRP us, and HOMA were evaluated by multivariate regression analysis. Results: Plasma triglycerides, insulin and HOMA were negatively related with WGSM and SGSM tertiles meaning a higher plaque lipid content and vulnerability. In multivariate analysis, triglycerides were significantly associated to low WGSM (p<0.003) and SGSM (p<0.018), whereas insulin only to low SGSM (p<0.012). Conclusion: The elevation in plasmatic triglycerides and insulin levels in patients with MetS are directly related with carotid plaques ECL, lipid content and vulnerability.