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http://dx.doi.org/10.3904/kjim.2015.30.1.73

Metabolic syndrome criteria as predictors of subclinical atherosclerosis based on the coronary calcium score  

Seo, Mi Hae (Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine)
Rhee, Eun-Jung (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Park, Se Eun (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Park, Cheol Young (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Oh, Ki Won (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Park, Sung Woo (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Lee, Won-Young (Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine)
Publication Information
The Korean journal of internal medicine / v.30, no.1, 2015 , pp. 73-81 More about this Journal
Abstract
Background/Aims: The aim was to determine which of three sets of metabolic syndrome (MetS) criteria (International Diabetes Federation [IDF], National Cholesterol Education Program Adult Treatment Panel III [ATP III], and European Group for the Study of Insulin Resistance [EGIR]) best predicts the coronary artery calcification (CAC) score in a cross-sectional study. This has not been evaluated in previous studies. Methods: A total of 24,060 subjects were screened for CAC by multi-detector computed tomography. The presence of CAC was defined as a CAC score > 0. The odds ratio for the presence of CAC was analyzed for three different sets of MetS criteria and according to number of MetS components. Results: CAC was observed in 12.6% (3,037) of the subjects. Patients with MetS, as defined by the IDF, ATP III, and EGIR criteria, had a CAC rate of 23.0%, 25.1%, and 29.5%, respectively (p < 0.001). Comparisons of C statistics for multivariate regression models revealed no significant difference among the three sets of criteria. After adjustment for risk factors, the ATP III criteria produced a slightly higher odds ratio for CAC compared with the other criteria, but this difference was not significant. The risk factor-adjusted odds ratio for the presence of CAC increased from 1 to 1.679 as the number of MetS components defined by ATP III increased from 0 to ${\geq}3$ (p for trend < 0.001). Conclusions: The presence of MetS was associated with the presence of CAC. There was no significant difference among the three sets of MetS criteria in terms of the ability to predict CAC. An increase in the number of MetS components was associated with an increased odds of CAC.
Keywords
Coronary artery; Calcification; Metabolic syndrome;
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1 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001;285:2486-2497.   DOI
2 Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005;365:1415-1428.   DOI
3 Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: definitions and controversies. BMC Med 2011;9:48.   DOI
4 Kim HC, Kim DJ. Causes of different estimates of the prevalence of metabolic syndrome in Korea. Korean J Intern Med 2011;26:440-448.   DOI
5 Detrano R, Guerci AD, Carr JJ, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-1345.   DOI
6 Mehta NN, Krishnamoorthy P, Martin SS, et al. Usefulness of insulin resistance estimation and the metabolic syndrome in predicting coronary atherosclerosis in type 2 diabetes mellitus. Am J Cardiol 2011;107:406-411.   DOI
7 Wong ND, Sciammarella MG, Polk D, et al. The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium. J Am Coll Cardiol 2003;41:1547-1553.   DOI
8 Blaha MJ, DeFilippis AP, Rivera JJ, et al. The relationship between insulin resistance and incidence and progression of coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2011;34:749-751.   DOI
9 American Diabetes Association. Standards of medical care in diabetes: 2014. Diabetes Care 2014;37 Suppl 1:S14-S80.   DOI
10 James PA, Oparil S, Carter BL, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507-520.   DOI
11 Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419.   DOI
12 Schwartz KL, Monsur JC, Bartoces MG, West PA, Neale AV. Correlation of same-visit HbA1c test with laboratory-based measurements: a MetroNet study. BMC Fam Pract 2005;6:28.   DOI
13 American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2004;27 Suppl 1:S15-S35.   DOI
14 Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990;15:827-832.   DOI
15 Lee S, Park HS, Kim SM, et al. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean J Obes 2006;15:1-9.
16 Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome: a new worldwide definition. Lancet 2005;366:1059-1062.   DOI
17 Balkau B, Charles MA. Comment on the provisional report from the WHO consultation: European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999;16:442-443.   DOI
18 DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988;44:837-845.   DOI
19 Orakzai SH, Orakzai RH, Nasir K, et al. Subclinical coronary atherosclerosis: racial profiling is necessary! Am Heart J 2006;152:819-827.   DOI
20 Yu JH, Yim SH, Yu SH, et al. The relationship of body composition and coronary artery calcification in apparently healthy korean adults. Endocrinol Metab (Seoul) 2013;28:33-40.   DOI
21 Ibebuogu UN, Ahmadi N, Hajsadeghi F, et al. Measures of coronary artery calcification and association with the metabolic syndrome and diabetes. J Cardiometab Syndr 2009;4:6-11.   DOI
22 Narla V, Santos RD, Campbell CY, et al. Coronary artery calcification and inflammation according to various metabolic syndrome definitions. J Cardiometab Syndr 2009;4:33-39.   DOI
23 Bonow RO. Clinical practice: should coronary calcium screening be used in cardiovascular prevention strategies? N Engl J Med 2009;361:990-997.   DOI
24 Simon A, Chironi G, Levenson J. Performance of subclinical arterial disease detection as a screening test for coronary heart disease. Hypertension 2006;48:392-396.   DOI
25 Toth PP. Subclinical atherosclerosis: what it is, what it means and what we can do about it. Int J Clin Pract 2008;62:1246-1254.   DOI
26 Sung KC, Wild SH, Byrne CD. Lipoprotein (a), metabolic syndrome and coronary calcium score in a large occupational cohort. Nutr Metab Cardiovasc Dis 2013;23:1239-1246.   DOI
27 Kramer CK, Zinman B, Gross JL, et al. Coronary artery calcium score prediction of all cause mortality and cardiovascular events in people with type 2 diabetes: systematic review and meta-analysis. BMJ 2013;346:f1654.   DOI
28 DeFronzo RA. Insulin resistance, lipotoxicity, type 2 diabetes and atherosclerosis: the missing links. The Claude Bernard Lecture 2009. Diabetologia 2010;53:1270-1287.   DOI
29 Semenkovich CF. Insulin resistance and atherosclerosis. J Clin Invest 2006;116:1813-1822.   DOI
30 Bornfeldt KE, Tabas I. Insulin resistance, hyperglycemia, and atherosclerosis. Cell Metab 2011;14:575-585.   DOI
31 Lakka HM, Laaksonen DE, Lakka TA, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002;288:2709-2716.   DOI
32 Budoff MJ, Achenbach S, Blumenthal RS, et al. Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 2006;114:1761-1791.
33 National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143-3421.
34 Detrano RC, Anderson M, Nelson J, et al. Coronary calcium measurements: effect of CT scanner type and calcium measure on rescan reproducibility: MESA study. Radiology 2005;236:477-484.   DOI