The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium

J Am Coll Cardiol. 2003 May 7;41(9):1547-53. doi: 10.1016/s0735-1097(03)00193-1.


Objectives: We compared the prevalence and extent of coronary artery calcium (CAC) among persons with the metabolic syndrome (MetS), diabetes, and neither condition.

Background: The prevalence and extent of CAC has not been compared among those with MetS, diabetes, or neither condition.

Methods: Of 1,823 persons (36% female) age 20 to 79 years who had screening for CAC by computed tomography, 279 had MetS, 150 had diabetes, and the remainder (n = 1,394) had neither condition. Metabolic syndrome was defined with >or=3 of the following: body mass index >or=30 kg/m(2); high-density lipoprotein cholesterol <40 mg/dl if male or <50 mg/dl if female; triglycerides >or=150 mg/dl; blood pressure >or=130/85 mm Hg or on treatment; or fasting glucose 110 to 125 mg/dl. The prevalence and odds of any and significant (>or=75th percentile) CAC among these groups and by number of MetS risk factors were determined.

Results: Those with neither MetS nor diabetes, MetS, or diabetes had a prevalence of CAC of 53.5%, 58.8%, and 75.3% (p < 0.001), respectively, among men and 37.6%, 50.8%, and 52.6% (p < 0.001), respectively, among women. Coronary artery calcium increased by the number (0 to 5) of MetS risk factors (from 34.0% to 58.3%) (p < 0.001). Forty-one percent of subjects with MetS had either a >20% 10-year risk of CHD or CAC >or=75th percentile for age and gender. Risk factor-adjusted odds for the presence of CAC were 1.40 (95% confidence interval [CI] 1.05 to 1.87) among those with MetS and 1.67 (95% CI 1.12 to 2.50) among those with diabetes, versus those with neither condition.

Conclusions: Those with MetS or diabetes have an increased likelihood of CAC compared with those having neither condition.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Calcinosis / complications*
  • Calcinosis / diagnostic imaging*
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / diagnostic imaging*
  • Diabetes Complications*
  • Diabetes Mellitus / diagnostic imaging*
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / diagnostic imaging*
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Tomography, X-Ray Computed