The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium

OBJECTIVES We compared the prevalence and extent of coronary artery calcium (CAC) among persons with the metabolic syndrome (MetS), diabetes, and neither condition. BACKGROUND The prevalence and extent of CAC has not been compared among those with MetS, diabetes, or neither condition. METHODS Of 1,823 persons (36% female) age 20 to 79 years who had screening for CAC by computed tomography, 279 had MetS, 150 had diabetes, and the remainder (n = 1,394) had neither condition. Metabolic syndrome was defined with greater than or equal to3 of the following: body mass index greater than or equal to30 kg/m(2); high-density lipoprotein cholesterol <40 mg/dl if male or <50 mg/dl if female; triglycerides greater than or equal to150 mg/dl; blood pressure greater than or equal to130/85 mm Hg or on treatment; or fasting glucose 110 to 125 mg/dl. The prevalence and odds of any and significant (greater than or equal to75th percentile) CAC among these groups and by number of MetS risk factors were determined. RESULTS Those with neither MetS nor diabetes, MetS, or diabetes had a prevalence of CAC of 53.5%, 58.8%, and 75.3% (p < 0.001), respectively, among men and 37.6%, 50.8%, and 52.6% (p < 0.001), respectively, among women. Coronary artery calcium increased by the number (0 to 5) of MetS risk factors (from 34.0% to 58.3%) (p < 0.001). Forty-one percent of subjects with MetS had either a >20% 10-year risk of CHD or CAC greater than or equal to75th percentile for age and gender. Risk factor-adjusted odds for the presence of CAC were 1.40 (95% confidence interval [CI] 1.05 to 1.87) among those with MetS and 1.67 (95% CI 1.12 to 2.50) among those with diabetes, versus those with neither condition. CONCLUSIONS Those with MetS or diabetes have an increased likelihood of CAC compared with those having neither condition. (C) 2003 by the American College of Cardiology Foundation.