Preserved flow-mediated dilation but delayed time-to-peak diameter in individuals with metabolic syndrome

Summary Introduction Inconsistent evidences of the metabolic syndrome (MetS) impact on vascular reactivity raise questions on flow‐mediated dilation (FMD) discriminatory power for disturbances induced by this clustering of risk factors. Previous reports, however, suggest that covariates such as the follow‐up of the artery diameter changes, the arterial size and shear stress affect FMD responses and consequently its discriminatory power for distinctive clinical profiles. Objective To determine the impact of MetS on traditional, arterial size‐ and shear‐rate‐adjusted FMD, the follow‐up‐derived time‐to‐peak diameter (TP), as well as their power for discriminating subjects with this clustering of risk factors from a sample of healthy individuals. Methods Twenty‐one MetS and ten healthy subjects underwent an assessment of endothelial function via FMD. Results Traditional and allometrically scaled FMD did not differ between groups (P>0·05) as well as the approach in which the covariate was the peak diameter shear rate. In the existence of MetS, TP was longer (67·7 ± 16·4 s versus healthy 42·1 ± 16·3 s, P = 0·001). ROC curve analysis indicated that TP (AUC = 0·871 [95% CI, 0·718–1·000]) had greater power of discrimination for MetS than FMD approaches. In addition, TP presented a moderate and significant association with sE‐selectin (r = 0·458, P = 0·048). Conclusion Time‐to‐peak diameter (TP) rather than FMD distinguished MetS from a healthy profile. Therefore, at least in subjects with MetS, TP may provide insights into the impact of this clustering of risk factors on the vascular phenotype.