Korean J Intern Med.  2015 Jan;30(1):73-81. 10.3904/kjim.2015.30.1.73.

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

• Seo MH
• Rhee EJ
• Park SE
• Park CY
• Oh KW
• Park SW
• Lee WY

• KMID: 2129666
• DOI: http://doi.org/10.3904/kjim.2015.30.1.73

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 > or = 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.

Keyword

Coronary artery; Calcification; Metabolic syndrome

MeSH Terms

Adult
Asymptomatic Diseases
Biological Markers/blood
Calcium/*analysis
Coronary Angiography/methods
Coronary Artery Disease/blood/*epidemiology/radiography
Coronary Vessels/*chemistry/radiography
Cross-Sectional Studies
Female
Humans
Male
Metabolic Syndrome X/blood/diagnosis/*epidemiology
Middle Aged
Multidetector Computed Tomography
Multivariate Analysis
Odds Ratio
Predictive Value of Tests
Prevalence
Republic of Korea/epidemiology
Risk Assessment
Risk Factors
Vascular Calcification/blood/*epidemiology/metabolism/radiography
Biological Markers
Calcium