High C reactive protein associated with increased pulse wave velocity among urban men with metabolic syndrome in Malaysia

Objectives: To determine the association between carotid femoral pulse wave velocity (PWV_CF); augmentation index (AI); and high-sensitivity C reactive protein (hs-CRP) with metabolic syndrome (MetS), and to determine the influence of ethnicity on PWV_CF and AI, and the association between high hs-CRP and increased PWV, and AI in MetS.Methods: A cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia from September 2009 to September 2011. Three hundred and eighty men (Chinese and Malays) were recruited from the study. The PWV_CF and AI were measured by Vicorder (SMT Medical, Wuerzburg, Germany). The hs-CRP level was also determined. We defined MetS using the International Diabetes Federation (IDF) and harmonized criteria. Results: Malays had higher AI compared to the Malaysian Chinese. Patients with MetS had higher PWV_CF (IDF criteria: 8.5 [8.3-8.7] versus 8.2 [8.0-8.4] m/s, p=0.03; harmonized criteria: 8.5 [8.4-8.7] versus 8.2 [8.0-8.4] m/s, p=0.007) and hs-CRP (IDF criteria: 0.9±2.0 versus 0.4±1.1 mg/L, p=0.0007; harmonized criteria: 0.8±1.9 versus 0.4±1.1 mg/L, p=0.002) compared to non-MetS. In subjects with MetS, those with high hs-CRP (>3mg/L) had higher PWV_CF. Conclusions: Augmentation index values were significantly higher in Malays compared with Malaysian Chinese. Metabolic syndrome was associated with increased PWV_CF and hs-CRP. Patients with MetS and high hs-CRP were associated with higher PWV_CF. The measurement of hs-CRP reflects the degree of subclinical vascular damage in MetS.