Measures of Coronary Artery Calcification and Association With the Metabolic Syndrome and Diabetes

The authors compared the metabolic syndrome status and Framingham 10-year coronary heart disease risk score (FRS) with the coronary artery calcification (CAC) in subclinical atherosclerosis. In all, 356 consecutive patients who underwent coronary artery calcium scanning were studied. Participants' metabolic syndrome status (by National Cholesterol Education Program Adult Treatment Panel III [NCEP ATP III] guidelines) and FRS were measured. The association between the metabolic syndrome, diabetes mellitus (DM), FRS, and CAC was analyzed by multivariable logistic regression analyses. These analyses were adjusted for demographics, age, sex, and conventional cardiovascular risk factors. The prevalence of significant CAC (CAC score >/=100) in those with DM, the metabolic syndrome, and neither condition was 64%, 43%, and 24%, respectively. The receiver operating characteristic C statistic for the prediction of significant CAC by the NCEP ATP III criteria for FRS, the metabolic syndrome, and DM was 0.61, 0.67, and 0.72, respectively, and increased significantly to 0.78 and 0.90 respectively for the metabolic syndrome and DM when added to the prediction models (P<.0001). This study suggests that the metabolic syndrome and DM are associated with increased risk of subclinical atherosclerosis. In addition, the presence of the metabolic syndrome or DM with increased FRS has incremental value over the FRS, DM, or the metabolic syndrome alone in predicting significant CAC.