Arterial Structure and Function After Recovery From the Metabolic Syndrome The Cardiovascular Risk in Young Finns Study

Background-The reversibility of ultrasonographic vascular changes associated with the metabolic syndrome (MetS) recovery is unknown. We examined whether spontaneous recovery from MetS (according to the International Diabetes Federation definition) has a favorable effect on vascular properties and evaluated the associations between lifestyle factors and MetS recovery. Methods and Results-We measured carotid artery intima-media thickness, distensibility, and brachial flow-mediated dilatation by ultrasound in 1673 subjects of the Young Finns Study cohort (age, 31.5 +/- 5.0 years in 2001) who participated in follow-up studies in 2001 and 2007. At baseline, no differences in intima-media thickness, carotid artery distensibility, or flow-mediated dilatation were observed between the recovery group (baseline-only MetS) and those with incident (only at follow-up) or persistent (both at baseline and follow-up) MetS. After 6 years, the recovery group had smaller intima-media thickness (mean +/- SEM, 0.62 +/- 0.01 versus 0.68 +/- 0.01 mm; P = 0.0009) and higher carotid artery distensibility (1.98 +/- 0.07%/mm Hg versus 1.56 +/- 0.04%/mm Hg; P = 0.001) compared with the persistent group and higher flow-mediated dilatation compared with the control group (9.91 +/- 0.51% versus 8.57 +/- 0.12%; P = 0.03). The recovery group had reduced intima-media thickness progression compared with the persistent group (0.036 +/- 0.005 versus 0.079 +/- 0.010 mm; P = 0.001) and reduced carotid artery distensibility change compared with the incident group (- 0.12 +/- 0.05%/mm Hg versus - 0.38 +/- 0.10%/mm Hg; P = 0.03) over the 6-year follow-up. Differences in carotid artery distensibility levels were attenuated (P = 0.11) after the inclusion of weight change in the models. MetS recovery was paralleled with significant reductions in waist circumference that independently correlated with increased physical activity and increased attention paid to health habits during the follow-up. Conclusion-Recovery from the MetS was associated with positive effects on vascular properties during a 6-year follow-up period of young adults. (Circulation. 2010;121:392-400.)