The significance of carotid artery atheromas on panoramic radiographs in the diagnosis of occult metabolic syndrome.
OBJECTIVE
Metabolic syndrome (MetS), the co-occurrence of abdominal obesity, hypertriglyceridemia, reduced HDL cholesterol, hypertension, and insulin resistance promotes carotid atherosclerosis and stroke. The objective of this study was to determine if the presence of calcified atheromas detected on panoramic radiographs of individuals free of overt vascular disease may herald occult MetS.


METHODS
Ninety-four individuals (mean age 65.6 years) with a calcified atheroma detected by a VA dental clinic were evaluated. A like-aged group was used for comparative analysis.


RESULTS
Fifteen percent of individuals (mean age 64 years) with an atheroma had occult MetS. Mean waist circumference was 116 cm, BMI 32.7 kg/m2, triglycerides 250 mg/dL, HDL cholesterol 35 mg/dL, blood pressure 147/87 mm Hg, and glucose 117 mg/dL. Only 6% of controls had occult MetS but this difference in prevalence was not proven to be statistically significant (P = .059).


CONCLUSIONS
Some individuals with a calcified atheroma may have undiagnosed MetS and should be referred to their physician because aggressive management may preclude a stroke.
Friedlander
Arthur H
AH
Graduate Medical Education, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA. arthur.friedlander@med.va.gov
Golub
Michael S
MS
D050153:Abdominal Fat; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D006801:Humans; D006973:Hypertension; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D011862:Radiography, Panoramic; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides