First Cardiology Department, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
Metab Syndr Relat Disord. 2010 Jun;8(3):201-8. doi: 10.1089/met.2009.0059.
The association of metabolic syndrome with coronary artery disease (CAD) has been studied extensively. However, little is known about the effect of Framingham risk score (FRS) and metabolic syndrome components on the association of metabolic syndrome with angiographically significant CAD. Our aim was to investigate whether that relationship is influenced by individual's 10-year CAD risk profile as assessed by FRS. Furthermore, we sought to elucidate whether metabolic syndrome is associated with angiographically significant CAD independently of its individual components.
We studied a consecutive sample of 150 patients undergoing coronary angiography for the evaluation of chest pain. Metabolic syndrome was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and the 10-year CAD risk was estimated by the FRS.
Metabolic syndrome patients had a 2-fold higher CAD prevalence compared to those without metabolic syndrome [odds ratio (OR), 2.004; 95% confidence interval (CI), 1.029-3.905] but this finding was attenuated after adjustment for FRS (OR, 1.770; 95% CI, 0.872-3.594). Stratification of patients into three groups according to FRS revealed that metabolic syndrome predictive ability was confined in those being at <10% 10-year CAD risk. Including metabolic syndrome and its individual components into the same logistic regression model, only the glucose criterion was an independent predictor of angiographically significant CAD (OR, 4.137; 95% CI, 1.477-11.583).
Metabolic syndrome is an independent determinant of angiographically significant CAD only among those individuals at low 10-year risk for future coronary events. Individual components of the syndrome, such as impaired fasting glucose, have a stronger association with CAD than the syndrome as a whole.
代谢综合征与冠状动脉疾病（CAD）的关联已得到广泛研究。然而，对于弗雷明汉风险评分（FRS）和代谢综合征成分对代谢综合征与血管造影显著 CAD 之间关联的影响知之甚少。我们的目的是研究代谢综合征与血管造影显著 CAD 的关系是否受 FRS 评估的个体 10 年 CAD 风险状况的影响。此外，我们还试图阐明代谢综合征是否独立于其各个成分与血管造影显著 CAD 相关。
我们研究了连续接受冠状动脉造影检查以评估胸痛的 150 例患者的样本。代谢综合征根据修订后的国家胆固醇教育计划成人治疗专家组 III（NCEP ATP III）标准定义，10 年 CAD 风险通过 FRS 估算。
与无代谢综合征的患者相比，代谢综合征患者的 CAD 患病率高两倍[优势比（OR），2.004；95%置信区间（CI），1.029-3.905]，但调整 FRS 后，这一发现减弱（OR，1.770；95%CI，0.872-3.594）。根据 FRS 将患者分为三组，发现代谢综合征的预测能力仅限于 10 年 CAD 风险<10%的患者。将代谢综合征及其各个成分纳入同一逻辑回归模型，只有血糖标准是血管造影显著 CAD 的独立预测因子（OR，4.137；95%CI，1.477-11.583）。
代谢综合征是血管造影显著 CAD 的独立决定因素，仅在未来发生冠状动脉事件的 10 年低风险个体中如此。该综合征的个体成分，如空腹血糖受损，与 CAD 的相关性强于该综合征整体。
