Association of metabolic syndrome and diabetes with subclinical coronary stenosis and plaque subtypes in middle-aged individuals

Abstract

The presence of subclinical stenosed coronary segments and plaque subtypes has not been compared among those with metabolic syndrome, diabetes, or neither condition in middle-aged individuals. In select, intermediate-risk subjects, it may be reasonable to directly measure atherosclerosis burden by low-dose, multidetector-row computed tomographic coronary angiography. We performed a cross-sectional analysis of 1024 consecutive, newly self-referred subjects (692 men, 332 women; mean age 53.0±9.7 years) who underwent health evaluation at the China Medical University Hospital. Participants had at least one cardiac risk factor, but no known coronary heart disease. Among our 1024 subjects, 135 had diabetes, 334 had metabolic syndrome and 555 had neither condition. The subjects with diabetes and those with metabolic syndrome had a higher prevalence of non-calcified, calcified and mixed-type plaques and stenosed coronary segments than the subjects with neither condition (P<0.05). The odds ratios for diabetes and the presence of any plaque, mixed plaque, calcified plaque and stenosed segment compared with neither metabolic syndrome nor diabetes were 2.893, 3.629, 2.099 and 2.036, respectively, all of which were significant (P<0.05). The odds ratio for metabolic syndrome and the presence of any plaque compared with neither metabolic syndrome nor diabetes was 1.606 (95% CI 1.063-2.426; P<0.05). In middle-aged subjects, diabetes was related to an increased risk of the presence of mixed plaques, calcified plaques and stenosed coronary segments. However, metabolic syndrome was related to an increased risk of the presence of any coronary plaque, but not related to stenosed coronary segments.