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J Am Coll Cardiol, 2003; 41:1547-1553, doi:10.1016/S0735-1097(03)00193-1 © 2003 by the American College of Cardiology Foundation |
* Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
Heart Disease Prevention Program, University of California, Irvine, California, USA
Manuscript received July 30, 2002; revised manuscript received November 12, 2002, accepted January 2, 2003.
* Reprint requests and correspondence: Dr. Daniel S. Berman, Department of Imaging, Cedars-Sinai Medical Center, 8700 Beverly Building, Room A041, Los Angeles, California 90048, USA.
bermand{at}cshs.org
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.
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