Indicators associated with coronary atherosclerosis in metabolic syndrome

Background: Metabolic factors associated with coronary atherosclerosis (CA) in metabolic syndrome (MetS) remain unclear. Methods: A 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. Results: After 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 ≥ 110. mg/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. Conclusions: MetS is independently associated with CA after adjustment of atherosclerotic biomarkers. TC/HDL-C ≥ 4.2 in MetS and fasting blood glucose ≥ 110. mg/dl/diabetes mellitus in non-MetS subjects are independent indicators of CA, suggesting the potential difference in pathophysiology of CA.