Key result
Metabolic syndrome was significantly associated with the presence of coronary artery calcification, with the odds of CAC increasing up to 1.68-fold as the number of ATP III components increased to 3 or more.
Why the study?
Which of three sets of metabolic syndrome criteria (IDF, ATP III, EGIR) best predicts the presence of coronary artery calcification in screened subjects?
Cross-Sectional (n=24,060)
No
Which of three sets of metabolic syndrome criteria (IDF, ATP III, EGIR) best predicts the presence of coronary artery calcification in screened subjects?
Odds Ratio: 1.436 (95% CI 1.286–1.603)
p-value: p=<0.001
The presence of metabolic syndrome is associated with coronary artery calcification, but there is no significant difference in predictive ability among the IDF, ATP III, and EGIR criteria.
Metabolic syndrome links to CAC across criteria; leaves open which definition best informs risk stratification in screened adults.
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 ≥ 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.
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Seo et al. (2015) conducted a cross-sectional in Metabolic Syndrome and Subclinical Atherosclerosis (n=24,060). Metabolic syndrome (ATP III criteria) vs. Absence of metabolic syndrome was evaluated on Presence of coronary artery calcification (CAC score > 0) (OR 1.436, 95% CI 1.286-1.603, p=<0.001). Metabolic syndrome was significantly associated with the presence of coronary artery calcification, with the odds of CAC increasing up to 1.68-fold as the number of ATP III components increased to 3 or more.
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