Evaluation of the relationship between atherogenic plasma index and pulse wave velocity with arterial stiffness in patients with metabolic syndrome

Objective: Metabolic syndrome (MetS) is a fatal endocrinopathy characterized by the combination of systemic disorders such as insulin resistance, abdominal obesity, glucose intolerance or type 2 diabetes, dyslipidemia, hypertension, and coronary artery disease (CAD). Arterial stiffness is defined as functional and structural changes in the arteries that occur as a result of aging, environmental, and genetic factors. Arterial stiffness is known to be an independent determinant of cardiovascular disease-related mortality. Metabolic syndrome, characterized by the clustering of cardiovascular disease risk factors, is also associated with increased arterial stiffness. Atherogenic Plasma Index (API) comprehensively reflects the balance between atherogenic and anti-atherogenic factors and is a powerful marker for predicting CAD risk. In our study, we aimed to investigate the relationship between the components of metabolic syndrome and atherogenic plasma index and pulse wave velocity in patients with metabolic syndrome. Materials and Methods: For our study, 55 cases meeting the pre-defined inclusion criteria and a control group of 26 individuals with a body mass index (BMI) below 30, similar in age and gender to the patient group, were selected from individuals aged 18-65 who presented to the Endocrinology Outpatient Clinic of Necmettin Erbakan University Hospital between March 2023 and August 2023. The patient and control groups were evaluated based on pulse wave velocity (PWV), API, and biochemical parameters, and the statistical analysis of the obtained data was performed. Results: This study, conducted at Necmettin Erbakan University Meram Faculty of Medicine Hospital Endocrinology and Metabolism Diseases Clinic, included 55 patients and 26 healthy individuals. Of the patient group, 50.9% (n=28) were female, while 55.0% (n=13) of the control group were female. The mean age of the patients was 54.96±8.16 years, and that of the control group was 51.31±10.72 years. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure vii (MAP), pulse pressure (PP), systolic blood pressure measured in the aorta, central pulse pressure (CPP), pulse wave velocity (PWV), and atherogenic plasma index (API) values were statistically higher in the patient group compared to the control group (p values, respectively; p<0.001; p=0.036; p<0.001; p<0.001; p<0.001; p=0.001; p<0.001; p<0.001). A positive and significantly strong correlation was found between API and TyG index. PWV showed a significantly strong positive correlation with age, a moderately positive correlation with systolic blood pressure and aortic systolic blood pressure, a positive correlation with mean arterial blood pressure, glycated hemoglobin (HbA1c), and urea, a low to moderate negative correlation with total cholesterol level, a significantly positive correlation with pulse pressure, a positive correlation with glucose, and a low significant negative correlation with LDL and GFR. Conclusion: In our study, it was demonstrated that pulse wave velocity increases in individuals with MetS, and the presence of metabolic syndrome is an independent determinant of arterial stiffness. In MetS individuals, SBP, MAP, HbA1c, glucose, and eGFR levels were found to be associated with arterial stiffness. No significant correlation was found between API and PWV, which are indicators of arterial stiffness. However, our study has a limited number of participants, and further studies with a larger patient population are needed.