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Coronary Artery Calcification and Inflammation According to Various Metabolic Syndrome Definitions


Erin D. Michos, MD, MHS, Division of Cardiology, Johns Hopkins School of Medicine, Carneige 568, 600 North Wolfe Street, Baltimore, MD 21287


A number of metabolic syndrome (MS) definitions exist, and one’s cardiovascular disease risk may depend on the definition used. The authors compared the association of subclinical atherosclerosis (coronary artery calcification [CAC] score >0] and inflammation (white blood cell [WBC] count greater than or equal to the highest quartile) with 3 definitions of MS (those of the National Cholesterol Education Program Adult Treatment Panel III [NCEP ATP III], the American Heart Association/National Heart, Lung and Blood Institute [AHA/NHLBI], and the International Diabetes Federation [IDF]) in 458 asymptomatic men (mean age, 46±7 years). MS was present in 28%, 29%, and 34% according to NCEP ATP III, AHA/NHLBI, and IDF criteria, respectively. CAC was observed in 40% and high WBC count in 24%. After adjustment for age, smoking, and low-density lipoprotein cholesterol, the odds ratios for CAC scores >0 with MS by NCEP ATP III, AHA/NHLBI, and IDF definitions were 1.67 (95% confidence interval [CI], 1.02–2.72), 1.67 (95% CI, 1.03–2.70), and 1.63 (95% CI, 1.03–2.57), respectively. The multivariate odds ratios for high WBC count with MS by NCEP ATP III, AHA/NHLBI, and IDF definitions were 1.69 (95% CI, 1.04–2.73), 1.84 (95% CI, 1.14–2.95), and 1.66 (95% CI, 1.05–2.62), respectively. MS is associated with increased subclinical atherosclerosis and inflammation irrespective of various definitions.