Indicators associated with coronary atherosclerosis in metabolic syndrome

Abstract

BackgroundMetabolic factors associated with coronary atherosclerosis (CA) in metabolic syndrome (MetS) remain unclear. MethodsA total of 550 consecutive subjects without documented coronary artery disease who received contrast-enhanced coronary computed tomography angiography were analyzed. CA was defined as coronary artery calcification (CAC) scores >0 or, zero CAC score combining noncalcified plaques within the proximal third segment of major coronary arteries. Metabolic factors and novel atherosclerotic biomarkers including high-sensitive C-reactive protein (hs-CRP) and adiponectin were measured. MetS was recognized according to the ethnicity-specific National Cholesterol Educational Program Adult Treatment Panel III, 2001. ResultsAfter adjusted with novel atherosclerotic biomarkers, MetS was significantly associated with CA Odds ratio [OR], 2.88; 95% confidence interval [CI], 1.88 to 4.42; p<0.001). Subgroup analysis revealed that fasting blood glucose ≥110mg/dl/diabetes mellitus in non-MetS subjects (OR, 1.40; 95%CI, 1.08 to 1.82; p<0.05) and total cholesterol (TC)/high density lipoprotein-cholesterol (HDL-C) ≥4.2 in MetS subjects (OR, 4.44; 95%CI, 1.93 to 10.20; p<0.001) were independently associated with CA. Both indicators were significantly associated with increased serum hs-CRP and reduced adiponectin levels in all subjects. ConclusionsMetS is independently associated with CA after adjustment of atherosclerotic biomarkers. TC/HDL-C ≥4.2 in MetS and fasting blood glucose ≥110mg/dl/diabetes mellitus in non-MetS subjects are independent indicators of CA, suggesting the potential difference in pathophysiology of CA.