Impaired coronary microvascular endothelial function in men with metabolic syndrome

Table 1 Patients’ characteristics regarding metabolic parameters (mean ± SE)

Variables	MS group	Non-MS group	P value
n (%)	24 (31)	56 (69)
Age (yr)	57 ± 2	57 ± 2	NS
Body mass index (kg/m2)	26.4 ± 0.6	24.3 ± 0.3	0.0089
Waist circumference (cm)	90 ± 1	86 ± 1	0.0114
MS risk factors, n (%)
Abdominal obesity	22 (92)	32 (59)	0.0042
Elevated triglyceride	18 (75)	22 (41)	0.0012
Low HDL cholesterol	11 (46)	5 (9)	0.0002
Hypertension	17 (71)	15 (28)	0.0004
Hyperglycemia	11 (46)	8 (15)	0.0032
Average MS score	3.3 ± 0.1	1.5 ± 0.1	< 0.0001

MS: Metabolic syndrome; NS: Not significant; HDL: High-density lipoprotein.

Table 2 Patients’ characteristics regarding other risk factors and medications (mean ± SE) n (%)

Variables	MS group	Non-MS group	P value
Other risk factors
Smoking	13 (54)	16 (35)	NS
Hypercholesterolemia1	6 (25)	10 (18)	NS
Total cholesterol (mg/dL)	206 ± 7	194 ± 5	NS
Triglyceride (mg/dL)	205 ± 17	157 ± 11	0.0218
HDL cholesterol (mg/dL)	44 ± 3	52 ± 2	0.0204
LDL cholesterol (mg/dL)	121 ± 6	111 ± 4	NS
Diabetes mellitus	5 (21)	5 (9)	0.0189
Fasting blood sugar (mg/dL)	107 ± 3	98 ± 2	0.0189
Hemoglobin A1C	5.7 ± 0.1	5.4 ± 0.1	0.0445
HOMA-IR	2.5 ± 0.2	1.7 ± 0.1	0.0046
C-reactive protein (mgl/L)	1.7 ± 0.3	1.3 ± 0.2	NS
Medications
Statins	1 (4)	6 (11)	NS
ACI or ARB	2 (8)	1 (2)	NS

¹On therapy and/or low-density lipoprotein (LDL)-cholesterol ≥ 140 mg/dL. MS: Metabolic syndrome; NS: Not significant; HDL: High-density lipoprotein; HOMA-IR: Homeostasis of assessment-insulin resistance; ACI: Angiotensin-converting enzyme inhibitor; ARB: Angiotensin receptor blocker.

Table 3 Hemodynamics and angiographic results (mean ± SE)

Variables	MS group		Non-MS group
	Value	% change	Value	% change
Baseline mean blood pressure (mmHg)	111 ± 2a		104 ± 2
Baseline heart rate (/min)	67 ± 2		64 ± 1
Coronary diameter (mm)
Baseline	3.26 ± 0.11	0	3.11 ± 0.07	0
ACh at 3 μg/min	3.30 ± 0.12	1.6 ± 1.4	3.18 ± 0.08	2.6 ± 0.7
ACh at 30 μg/min	3.23 ± 0.13	-0.5 ± 1.9	3.08 ± 0.09	-0.5 ± 1.3
Nitroglycerin	3.67 ± 0.12	13.9 ± 2.3	3.54 ± 0.08	14.7 ± 1.6
Coronary blood flow (mL/min)
Baseline	77 ± 6	0	65 ± 4	0
ACh at 3 μg/min	110 ± 14	38 ± 9b	114 ± 9	73 ± 6
ACh at 30 μg/min	137 ± 20a	82 ± 18d	190 ± 13	198 ± 12
Coronary flow reserve	3.3 ± 0.2		3.6 ± 0.1

MS: Metabolic syndrome; ACh: Acetylcholine.

^aP < 0.05 vs values in non-MS group;

^bP < 0.01,

^dP < 0.001 vs % change in non-MS group.

Table 4 Multivariate analysis of variables influencing % change in coronary blood flow induced by acetylcholine at 30 μg/min

Variables	% change in coronary blood flow induced by ACh 30μg/min
	t value	P value
Presence of MS	-5.07	< 0.0001
Coronary flow reserve	3.62	0.0005
C-reactive protein	-2.76	0.0073
Baseline heart rate	-1.13	0.262

ACh: Acetylcholine; MS: Metabolic syndrome.