Key result
Metabolic syndrome score independently predicted angiographic coronary artery disease (OR 1.452 per 1 point increase), but this predictive value was lost in patients with diabetes.
Why the study?
Does metabolic syndrome score predict angiographic coronary artery disease severity and correlate with inflammatory markers differently based on the presence of diabetes mellitus?
Cross-Sectional (n=363)
No
Does metabolic syndrome score predict angiographic coronary artery disease severity and correlate with inflammatory markers differently based on the presence of diabetes mellitus?
Odds Ratio: 1.452 (95% CI 1.109–1.901)
p-value: p=0.007
Metabolic syndrome score and adiponectin levels independently predict angiographic CAD severity in non-diabetic patients, but lose their predictive value in the presence of diabetes.
Metabolic syndrome score should not guide CAD assessment in diabetes; leaves open its differential value and mechanisms by diabetes status.
BACKGROUND: It is a matter of debate whether metabolic syndrome (MS) improves cardiovascular risk prediction beyond the risk associated with its individual components. The present study examined the association of MS score with high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), resistin, adiponectin, and angiographic coronary artery disease (CAD) severity according to the presence of DM. In addition, the predictive value of various clinical and biochemical parameters were analyzed, including the MS score for angiographic CAD. METHODS: The study enrolled 363 consecutive patients (196 men, 62 ± 11 years of age) who underwent coronary angiography for evaluation of chest pain. Blood samples were taken prior to elective coronary angiography. MS was defined by the National Cholesterol Education Program criteria, with MS score defined as the numbers of MS components. CAD was defined as > 50% luminal diameter stenosis of at least one major epicardial coronary artery. CAD severity was assessed using the Gensini score. RESULTS: Of the 363 patients studied, 174 (48%) had CAD and 178 (49%) were diagnosed with MS. When the patients were divided into 4 subgroups according to MS score (0-1, 2, 3, 4-5), IL-6 levels and the CAD severity as assessed by the Gensini score increased as MS scores increased. In contrast, adiponectin levels decreased significantly as MS scores increased. When subjects were divided into two groups according to the presence of DM, the relationships between MS score and IL-6, adiponectin, and Gensini score were maintained only in patients without DM. Age, smoking, DM, MS score, and adiponectin independently predicted angiographic CAD in the whole population. However, age is the only predictor for angiographic CAD in patients with DM. CONCLUSIONS: In the presence of DM, neither adipokines nor MS score predicted angiographic CAD. However, in non-diabetic patients, IL-6 and adiponectin showed progressive changes according to MS score, and MS score was an independent predictor of CAD in patients without DM.
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Kim et al. (2013) conducted a cross-sectional in Chest pain undergoing elective coronary angiography (n=363). Metabolic syndrome score vs. Lower metabolic syndrome score was evaluated on Angiographic coronary artery disease (OR 1.452, 95% CI 1.109-1.901, p=0.007). Metabolic syndrome score independently predicted angiographic coronary artery disease (OR 1.452 per 1 point increase), but this predictive value was lost in patients with diabetes.
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