The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium

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OBJECTIVES: We compared the prevalence and extent of coronary artery calcium (CAC) among persons with the metabolic syndrome (MetS), diabetes, and neither condition. BACKGROUND: The prevalence and extent of CAC has not been compared among those with MetS, diabetes, or neither condition. METHODS: Of 1,823 persons (36% female) age 20 to 79 years who had screening for CAC by computed tomography, 279 had MetS, 150 had diabetes, and the remainder (n = 1,394) had neither condition. Metabolic syndrome was defined with ≥3 of the following: body mass index ≥30 kg/m2; high-density lipoprotein cholesterol <40 mg/dl if male or <50 mg/dl if female; triglycerides ≥150 mg/dl; blood pressure ≥130/85 mm Hg or on treatment; or fasting glucose 110 to 125 mg/dl. The prevalence and odds of any and significant (≥75th percentile) CAC among these groups and by number of MetS risk factors were determined. RESULTS: Those with neither MetS nor diabetes, MetS, or diabetes had a prevalence of CAC of 53.5%, 58.8%, and 75.3% (p < 0.001), respectively, among men and 37.6%, 50.8%, and 52.6% (p < 0.001), respectively, among women. Coronary artery calcium increased by the number (0 to 5) of MetS risk factors (from 34.0% to 58.3%) (p < 0.001). Forty-one percent of subjects with MetS had either a >20% 10-year risk of CHD or CAC ≥75th percentile for age and gender. Risk factor-adjusted odds for the presence of CAC were 1.40 (95% confidence interval [CI] 1.05 to 1.87) among those with MetS and 1.67 (95% CI 1.12 to 2.50) among those with diabetes, versus those with neither condition. CONCLUSIONS: Those with MetS or diabetes have an increased likelihood of CAC compared with those having neither condition. © 2003 by the American College of Cardiology Foundation.




Wong, N. D., Sciammarella, M. G., Polk, D., Gallagher, A., Miranda-Peats, L., Whitcomb, B., … Berman, D. S. (2003). The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium. Journal of the American College of Cardiology, 41(9), 1547–1553.

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