Metabolic Syndrome Is a Risk Factor for Coronary Artery Disease in a Tunisian Population

BACKGROUND: Metabolic syndrome is a constellation of disorders that produces a high risk of atherosclerosis. The prevalence of metabolic syndrome clearly varies depending on ethnicity. The aim of this study was to investigate the prevalence of metabolic syndrome and its relationship with significant coronary stenosis (SCS) in a Tunisian population. METHODS: Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. SCS was defined as a luminal narrowing of more or equal to 50% in at least 1 major coronary artery, as judged by coronary angiography. A total of 192 subjects documented by coronary angiography were recruited from the cardiology department. RESULTS: In all, 54.2% (n = 104) of patients presented with metabolic syndrome, with a higher prevalence among women (65.9% vs. 45.5%; P = 0.004). In the subjects with metabolic syndrome, the fasting hyperglycemia was the most common metabolic disorder (86.5%). The risk of SCS increased approximately 3-fold in the presence of metabolic syndrome [odds ratio (OR) = 3.38, P = 0.004]. In addition, SCS risk was increased according to the increase in the number of metabolic syndrome components. The most atherogenic profile was that which assembled five metabolic syndorme components (OR = 4.18, P = 0.001). There was a significant relationship between the homeostasis model of insulin resistance (HOMA-IR) and the risk of SCS in the presence of metabolic syndrome. In fact, the OR of SCS associated with metabolic syndrome was (4.96, P = 0.001) in participants in the highest quartile of HOMA-IR. CONCLUSIONS: This study suggests that metabolic syndrome is a risk factor for SCS. The detection, prevention, and treatment of the underlying risk factors of metabolic syndrome should become an important approach for reduction of the cardiovascular disease burden in our study population.