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

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Background/Aims: The aim was to determine which of three sets of metabolicsyndrome (MetS) criteria (International Diabetes Federation [IDF], National CholesterolEducation Program Adult Treatment Panel III [ATP III], and EuropeanGroup for the Study of Insulin Resistance [EGIR]) best predicts the coronary arterycalcification (CAC) score in a cross-sectional study. This has not been evaluatedin previous studies. Methods: A total of 24,060 subjects were screened for CAC by multi-detector computedtomography. The presence of CAC was defined as a CAC score > 0. The oddsratio for the presence of CAC was analyzed for three different sets of MetS criteriaand according to number of MetS components. Results: CAC was observed in 12.6% (3,037) of the subjects. Patients with MetS, asdefined 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 multivariateregression models revealed no significant difference among the three sets of criteria. After adjustment for risk factors, the ATP III criteria produced a slightlyhigher odds ratio for CAC compared with the other criteria, but this differencewas not significant. The risk factor-adjusted odds ratio for the presence of CACincreased from 1 to 1.679 as the number of MetS components defined by ATP IIIincreased from 0 to ≥ 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 interms of the ability to predict CAC. An increase in the number of MetS componentswas associated with an increased odds of CAC.

Abstract

Background/Aims: The aim was to determine which of three sets of metabolicsyndrome (MetS) criteria (International Diabetes Federation [IDF], National CholesterolEducation Program Adult Treatment Panel III [ATP III], and EuropeanGroup for the Study of Insulin Resistance [EGIR]) best predicts the coronary arterycalcification (CAC) score in a cross-sectional study. This has not been evaluatedin previous studies. Methods: A total of 24,060 subjects were screened for CAC by multi-detector computedtomography. The presence of CAC was defined as a CAC score > 0. The oddsratio for the presence of CAC was analyzed for three different sets of MetS criteriaand according to number of MetS components. Results: CAC was observed in 12.6% (3,037) of the subjects. Patients with MetS, asdefined 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 multivariateregression models revealed no significant difference among the three sets of criteria. After adjustment for risk factors, the ATP III criteria produced a slightlyhigher odds ratio for CAC compared with the other criteria, but this differencewas not significant. The risk factor-adjusted odds ratio for the presence of CACincreased from 1 to 1.679 as the number of MetS components defined by ATP IIIincreased from 0 to ≥ 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 interms of the ability to predict CAC. An increase in the number of MetS componentswas associated with an increased odds of CAC.

참고문헌 (34)

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