Roles of the metabolic syndrome, HDL cholesterol, and coronary atherosclerosis in subclinical inflammation.
OBJECTIVE
The metabolic syndrome (MetS) and coronary artery disease (CAD) frequently coincide; their individual contribution to inflammation is unknown.


METHODS
We enrolled 1,010 patients undergoing coronary angiography. Coronary stenoses >or=50% were considered significant. The MetS was defined according to American Heart Association-revised National Cholesterol Education Program Adult Treatment Panel III criteria.


RESULTS
C-reactive protein (CRP) did not differ between patients with significant CAD and subjects without significant CAD (P = 0.706) but was significantly higher in MetS patients than in those without MetS (P < 0.001). The MetS criteria low HDL cholesterol (P < 0.001), large waist (P < 0.001), high glucose (P < 0.001), and high blood pressure (P = 0.016), but not high triglycerides (P = 0.352), proved associated with CRP. When all MetS traits were considered simultaneously, only low HDL cholesterol proved independently associated with CRP (F = 44.19; P < 0.001).


CONCLUSIONS
CRP is strongly associated with the MetS but not with coronary atherosclerosis. The association of the MetS with subclinical inflammation is driven by the low HDL cholesterol feature.
Rein
Philipp
P
Vorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria.
Saely
Christoph H
CH
Beer
Stefan
S
Vonbank
Alexander
A
Drexel
Heinz
H
D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000378:metabolism*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000378:metabolism*; D006801:Humans; D024821:Metabolic Syndrome / Q000378:metabolism*; D012307:Risk Factors
D008076:Cholesterol, HDL; D002097:C-Reactive Protein