Association of Metabolic Syndrome and Ischemic Changes in ECG: Result from a Population-Based Study

Background Metabolic syndrome (MetS) is a set of metabolic impairments that are all risk factors for cardiovascular diseases (CVDs). To distinguish and anticipate the CVD risk, an electrocardiogram (ECG) can be utilized. While the exact association between MetS components and ECG abnormalities isn’t well established yet, we designed this study to verify the association between MetS components and ischemic ECG presentations. Methods This cross-sectional study was conducted on individuals aged 35–65 years as part of the population-based Mashhad stroke and heart atherosclerotic disorder (MASHAD) study. International Diabetes Federation (IDF) criteria were utilized to categorize the participants into two groups: those with and without MetS. ECGs were coded using the Minnesota coding system. The association between each MetS component and every single ischemic ECG presentation was analysed separately. Results Among the 9035 available ECG data, the general prevalence of ischemic ECG presentation was significantly higher in those with MetS than in those without (p < 0.05), except for minor ischemia (P = 0.787). Multiple logistic regression analysis showed that MetS was independently associated with major ischemia presentation in ECG (OR = 1.254, 95% Cl: 1.103–1.425, P < 0.001), but there wasn’t any association found with minor ischemia, after adjustment for age, sex, smoking, CVD family history, and physical activity level. Among Mets components, triglycerides, fasting blood glucose, waist circumference, and systolic and diastolic blood pressures had significantly positive associations with ischemic ECG presentations in the case of any association. Elevated high-density lipoprotein cholesterol level had negative associations with ischemic ECG presentations, while it had a significant positive association only with ST-segment elevation (OR = 1.021, 95% Cl: 1.011–1.031, P < 0.001). Conclusions MetS and its components showed an association with ischemic ECG presentations, but these associations were diverse, based on each MetS component and ischemic ECG abnormality.