Advertisement

Submit Manuscripts
Author Information
Subscribe/Renew
Order Reprints
Email Alerts
Feedback
RSS Feed
CME

About the Journal
Editorial Board & Staff

JACC Imaging Homepage JACC Interventions Homepage
Still not a subscriber to JACC Imaging or JACC Interventions?
Click here
to sign up now!

ACC.org
Cardiosmart
Cardiosource
CVN
Imaging Library
JACC Imaging
JACC Interventions

Click here for more guidelines.
ACCF/ASNC/ACR/
AHA/ASE/SCCT/
SCMR/SNM 2009 Appropriate Use Criteria for Cardiac Radionuclide Imaging
SCIENCE ADVISORY: Percutaneous Device Closure of Patent Foramen Ovale for Secondary Stroke Prevention
ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hypertension
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2003; 41:1547-1553, doi:10.1016/S0735-1097(03)00193-1
© 2003 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wong, N. D.
Right arrow Articles by Berman, D. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wong, N. D.
Right arrow Articles by Berman, D. S.

CLINICAL STUDY

The metabolic syndrome, diabetes, and subclinicalatherosclerosis assessed by coronary calcium

Nathan D. Wong, PhD, FACC{dagger}, Maria G. Sciammarella, MD*, Donna Polk, MD, MPH*, Amy Gallagher, MPH*, Lisa Miranda-Peats, MPH*, Brian Whitcomb, BS*, Rory Hachamovitch, MD, FACC*, John D. Friedman, MD, FACC*, Sean Hayes, MD* and Daniel S. Berman, MD, FACC*,*

* Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, USA
{dagger} 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.

Abbreviations and Acronyms
  ATP = Adult Treatment Panel
  BMI = body mass index
  CAC = coronary artery calcium
  CHD = coronary heart disease
  CI = confidence interval
  HDL = high-density lipoprotein
  HU = Hounsfield units
  LDL = low-density lipoprotein
  MetS = metabolic syndrome
  NCEP = National Cholesterol Education Program
  OR = odds ratio




This article has been cited by other articles:


Home page
 DiabetesHome page
R. Katz, M. J. Budoff, J. Takasu, D. M. Shavelle, A. Bertoni, R. S. Blumenthal, P. Ouyang, N. D. Wong, and K. D. O'Brien
Relationship of Metabolic Syndrome With Incident Aortic Valve Calcium and Aortic Valve Calcium Progression: The Multi-Ethnic Study of Atherosclerosis (MESA)
Diabetes, April 1, 2009; 58(4): 813 - 819.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
M. Inzitari, B. L. Naydeck, and A. B. Newman
Coronary Artery Calcium and Physical Function in Older Adults: The Cardiovascular Health Study
J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2008; 63(10): 1112 - 1118.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Sorajja, A. S. Gami, V. K. Somers, T. R. Behrenbeck, A. Garcia-Touchard, and F. Lopez-Jimenez
Independent Association Between Obstructive Sleep Apnea and Subclinical Coronary Artery Disease
Chest, April 1, 2008; 133(4): 927 - 933.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
A. G. Bertoni, N. D. Wong, S. Shea, S. Ma, K. Liu, S. Preethi, D. R. Jacobs Jr, C. Wu, M. F. Saad, and M. Szklo
Insulin Resistance, Metabolic Syndrome, and Subclinical Atherosclerosis: The Multi-Ethnic Study of Atherosclerosis (MESA)
Diabetes Care, November 1, 2007; 30(11): 2951 - 2956.
[Abstract] [Full Text] [PDF]

Home page
 HeartHome page
C A Daly, P Hildebrandt, M Bertrand, R Ferrari, W Remme, M Simoons, K M Fox, and on behalf of the EUROPA investigators
Adverse prognosis associated with the metabolic syndrome in established coronary artery disease: data from the EUROPA trial
Heart, November 1, 2007; 93(11): 1406 - 1411.
[Abstract] [Full Text] [PDF]

Home page
 DiabetesHome page
E. Ingelsson, L. M. Sullivan, J. M. Murabito, C. S. Fox, E. J. Benjamin, J. F. Polak, J. B. Meigs, M. J. Keyes, C. J. O'Donnell, T. J. Wang, et al.
Prevalence and Prognostic Impact of Subclinical Cardiovascular Disease in Individuals With the Metabolic Syndrome and Diabetes
Diabetes, June 1, 2007; 56(6): 1718 - 1726.
[Abstract] [Full Text] [PDF]

Home page
 DiabetesHome page
T. Mazzone, P. M. Meyer, G. T. Kondos, M. H. Davidson, S. B. Feinstein, R. B. D'Agostino Sr., A. Perez, and S. M. Haffner
Relationship of Traditional and Nontraditional Cardiovascular Risk Factors to Coronary Artery Calcium in Type 2 Diabetes
Diabetes, March 1, 2007; 56(3): 849 - 855.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
C. Iribarren, A. S. Go, G. Husson, S. Sidney, J. M. Fair, T. Quertermous, M. A. Hlatky, and S. P. Fortmann
Metabolic Syndrome and Early-Onset Coronary Artery Disease: Is the Whole Greater Than Its Parts?
J. Am. Coll. Cardiol., November 7, 2006; 48(9): 1800 - 1807.
[Abstract] [Full Text] [PDF]

Home page
 HypertensionHome page
N. Ishizaka, Y. Ishizaka, H. Hashimoto, E.-I. Toda, R. Nagai, and M. Yamakado
Metabolic Syndrome May Not Associate With Carotid Plaque in Subjects With Optimal, Normal, or High-Normal Blood Pressure
Hypertension, September 1, 2006; 48(3): 411 - 417.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
D. S. Berman, R. Hachamovitch, L. J. Shaw, J. D. Friedman, S. W. Hayes, L. E.J. Thomson, D. S. Fieno, G. Germano, N. D. Wong, X. Kang, et al.
Roles of Nuclear Cardiology, Cardiac Computed Tomography, and Cardiac Magnetic Resonance: Noninvasive Risk Stratification and a Conceptual Framework for the Selection of Noninvasive Imaging Tests in Patients with Known or Suspected Coronary Artery Disease
J. Nucl. Med., July 1, 2006; 47(7): 1107 - 1118.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
R. Katz, N. D. Wong, R. Kronmal, J. Takasu, D. M. Shavelle, J. L. Probstfield, A. G. Bertoni, M. J. Budoff, and K. D. O'Brien
Features of the Metabolic Syndrome and Diabetes Mellitus as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis
Circulation, May 2, 2006; 113(17): 2113 - 2119.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
L. J. Shaw, C. N. Bairey Merz, C. J. Pepine, S. E. Reis, V. Bittner, S. F. Kelsey, M. Olson, B. D. Johnson, S. Mankad, B. L. Sharaf, et al.
Insights From the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study: Part I: Gender Differences in Traditional and Novel Risk Factors, Symptom Evaluation, and Gender-Optimized Diagnostic Strategies
J. Am. Coll. Cardiol., February 7, 2006; 47(3_Suppl_S): S4 - S20.
[Abstract] [Full Text] [PDF]

Home page
 British Journal of Diabetes & Vascular DiseaseHome page
N. D Wong
Review: Cardiovascular risk assessment in the metabolic syndrome, screening for subclinical disease, and implications for treatment
The British Journal of Diabetes & Vascular Disease, November 1, 2005; 5(6): 305 - 313.
[Abstract] [PDF]

Home page
 Diabetes CareHome page
N. D. Wong and S. Malik
C-Reactive Protein for Cardiovascular Risk Assessment in the Metabolic Syndrome
Diabetes Care, October 1, 2005; 28(10): 2598 - 2599.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
Z. T. Bloomgarden
Inflammation, Atherosclerosis, and Aspects of Insulin Action
Diabetes Care, September 1, 2005; 28(9): 2312 - 2319.
[Full Text] [PDF]

Home page
 Am J EpidemiolHome page
C. J. Girman, J. M. Dekker, T. Rhodes, G. Nijpels, C. D. A. Stehouwer, L. M. Bouter, and R. J. Heine
An Exploratory Analysis of Criteria for the Metabolic Syndrome and Its Prediction of Long-term Cardiovascular Outcomes: The Hoorn Study
Am. J. Epidemiol., September 1, 2005; 162(5): 438 - 447.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
W. S. Tzou, P. S. Douglas, S. R. Srinivasan, M. G. Bond, R. Tang, W. Chen, G. S. Berenson, and J. H. Stein
Increased Subclinical Atherosclerosis in Young Adults With Metabolic Syndrome: The Bogalusa Heart Study
J. Am. Coll. Cardiol., August 2, 2005; 46(3): 457 - 463.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
N. D. Wong, A. Rozanski, H. Gransar, R. Miranda-Peats, X. Kang, S. Hayes, L. Shaw, J. Friedman, D. Polk, and D. S. Berman
Metabolic Syndrome and Diabetes Are Associated With an Increased Likelihood of Inducible Myocardial Ischemia Among Patients With Subclinical Atherosclerosis
Diabetes Care, June 1, 2005; 28(6): 1445 - 1450.
[Abstract] [Full Text] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
N. Ishizaka, Y. Ishizaka, E.-I. Toda, R. Nagai, and M. Yamakado
Association Between Serum Uric Acid, Metabolic Syndrome, and Carotid Atherosclerosis in Japanese Individuals
Arterioscler. Thromb. Vasc. Biol., May 1, 2005; 25(5): 1038 - 1044.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
T. Takamiya, W. R. Zaky, D. Edmundowics, T. Kadowaki, H. Ueshima, L. H. Kuller, and A. Sekikawa
World Health Organization-Defined Metabolic Syndrome Is a Better Predictor of Coronary Calcium Than the Adult Treatment Panel III Criteria in American Men Aged 40-49 Years
Diabetes Care, December 1, 2004; 27(12): 2977 - 2979.
[Full Text] [PDF]

Home page
 CirculationHome page
S. Malik, N. D. Wong, S. S. Franklin, T. V. Kamath, G. J. L'Italien, J. R. Pio, and G. R. Williams
Impact of the Metabolic Syndrome on Mortality From Coronary Heart Disease, Cardiovascular Disease, and All Causes in United States Adults
Circulation, September 7, 2004; 110(10): 1245 - 1250.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. S. Berman, N. D. Wong, H. Gransar, R. Miranda-Peats, J. Dahlbeck, S. W. Hayes, J. D. Friedman, X. Kang, D. Polk, R. Hachamovitch, et al.
Relationship between stress-induced myocardial ischemia and atherosclerosis measured by coronary calcium tomography
J. Am. Coll. Cardiol., August 18, 2004; 44(4): 923 - 930.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
M. P. Reilly, M. L. Wolfe, T. Rhodes, C. Girman, N. Mehta, and D. J. Rader
Measures of Insulin Resistance Add Incremental Value to the Clinical Diagnosis of Metabolic Syndrome in Association With Coronary Atherosclerosis
Circulation, August 17, 2004; 110(7): 803 - 809.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. S. Berman and N. D. Wong
Implications of estimating coronary heart disease risk in the U.S. population
J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1797 - 1798.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
G. Schillaci, M. Pirro, G. Vaudo, F. Gemelli, S. Marchesi, C. Porcellati, and E. Mannarino
Prognostic value of the metabolic syndrome in essential hypertension
J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1817 - 1822.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
P. Raggi, L. J. Shaw, D. S. Berman, and T. Q. Callister
Prognostic value of coronary artery calcium screening in subjects with and without diabetes
J. Am. Coll. Cardiol., May 5, 2004; 43(9): 1663 - 1669.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
O. C. Marroquin, K. E. Kip, D. E. Kelley, B. D. Johnson, L. J. Shaw, C. N. Bairey Merz, B. L. Sharaf, C. J. Pepine, G. Sopko, S. E. Reis, et al.
Metabolic Syndrome Modifies the Cardiovascular Risk Associated With Angiographic Coronary Artery Disease in Women: A Report From the Women's Ischemia Syndrome Evaluation
Circulation, February 17, 2004; 109(6): 714 - 721.
[Abstract] [Full Text] [PDF]


 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement