The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium.
OBJECTIVE
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 >or=3 of the following: body mass index >or=30 kg/m(2); high-density lipoprotein cholesterol <40 mg/dl if male or <50 mg/dl if female; triglycerides >or=150 mg/dl; blood pressure >or=130/85 mm Hg or on treatment; or fasting glucose 110 to 125 mg/dl. The prevalence and odds of any and significant (>or=75th 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 >or=75th 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.
Heart Disease Prevention Program, University of California, Irvine, California, USA.
Nathan D
ND
Wong
Maria G
MG
Sciammarella
Donna
D
Polk
Amy
A
Gallagher
Lisa
L
Miranda-Peats
Brian
B
Whitcomb
Rory
R
Hachamovitch
John D
JD
Friedman
Sean
S
Hayes
Daniel S
DS
Berman
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000150:complications* / Q000000981:diagnostic imaging*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D014057:Tomography, X-Ray Computed