Email updates

Keep up to date with the latest news and content from BMC Cardiovascular Disorders and BioMed Central.

Open Access Highly Accessed Research article

Differential association between metabolic syndrome and coronary artery disease evaluated with cardiac computed tomography according to the presence of diabetes in a symptomatic Korean population

Ki-Bum Won12, Hyuk-Jae Chang156*, Jimin Sung3, Sanghoon Shin1, In-Jeong Cho1, Chi-Young Shim1, Geu-Ru Hong1, Young Jin Kim4, Byung-Wook Choi4 and Namsik Chung1

Author Affiliations

1 Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Republic of Korea

2 Division of Cardiology, St. Luke’s International Hospital, Tokyo, Japan

3 Graduate School of Health and Welfare CHA University, Seongnam, Republic of Korea

4 Division of Radiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Republic of Korea

5 Severance Biomedical Science Institute, Seoul, Republic of Korea

6 Yonsei Cardiovascular Center, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752 Republic of Korea

For all author emails, please log on.

BMC Cardiovascular Disorders 2014, 14:105  doi:10.1186/1471-2261-14-105

Published: 20 August 2014

Abstract

Background

Metabolic syndrome (MetS) is associated with increased risks of diabetes and coronary artery disease (CAD). Despite the controversial inclusion of established diabetes in MetS, the association between MetS and CAD according to diabetes status has not been elucidated in the Asian population.

Methods

We evaluated the association between MetS and CAD using the parameters including any plaque, obstructive plaque, and coronary artery calcium score (CACS) >100 according to diabetes status in 2,869 symptomatic Korean subjects who underwent cardiac computed tomographic angiography.

Results

The prevalence of MetS was significantly higher in the diabetic subjects than in the non-diabetic subjects (69% vs. 34%, P <0.001). The incidence of any plaque (64% vs. 43%, P <0.001), obstructive plaque (26% vs. 13%, P = 0.006), and CACS >100 (23% vs. 12%, P = 0.012) was significantly higher in diabetic subjects than in non-diabetic subjects. Among the MetS components, decreased high-density lipoprotein level was significantly associated with any plaque (odds ratio [OR] 1.35), obstructive plaque (OR 1.55), and CACS >100 (OR 1.57) in the non-diabetic subjects (P <0.01, respectively). However, none of the MetS components were associated with all the parameters in the diabetic subjects. Multivariate regression analysis revealed that MetS and the number of MetS components (MetSN) were independently associated with any plaque (MetS: OR 1.55, P <0.001; MetSN: OR 1.22, P <0.001), obstructive plaque (MetS: OR 1.52, P = 0.003; MetSN: OR 1.25, P <0.001), and CACS >100 (MetS: OR 1.46, P = 0.015; MetSN: OR 1.21, P = 0.004) only in the non-diabetic subjects, respectively.

Conclusions

MetS was independently associated with the presence and severity of CAD only in the non-diabetic subjects among the symptomatic Korean population.

Keywords:
Metabolic syndrome; Diabetes; Coronary artery disease; Coronary computed tomographic angiography