Cardiovascular Research Center, and School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
Clin Chim Acta. 2012 Jan 18;413(1-2):226-31. doi: 10.1016/j.cca.2011.09.033. Epub 2011 Oct 5.
Metabolic factors associated with coronary atherosclerosis (CA) in metabolic syndrome (MetS) remain unclear.
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.
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.
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.
代谢综合征（MetS）中与冠状动脉粥样硬化（CA）相关的代谢因素仍不清楚。
对 550 例连续接受对比增强冠状动脉计算机断层扫描血管造影术的无冠心病病史患者进行分析。CA 定义为冠状动脉钙化（CAC）评分>0 或近端三分之一段主要冠状动脉内无钙化斑块的 CAC 评分为 0。测量代谢因素和新型动脉粥样硬化生物标志物，包括高敏 C 反应蛋白（hs-CRP）和脂联素。MetS 根据特定种族的国家胆固醇教育计划成人治疗专家组 III，2001 年标准进行识别。
在调整新型动脉粥样硬化生物标志物后，MetS 与 CA 显著相关，比值比[OR]为 2.88；95%置信区间[CI]为 1.88 至 4.42；p<0.001）。亚组分析显示，非 MetS 患者空腹血糖≥110mg/dl/糖尿病（OR，1.40；95%CI，1.08 至 1.82；p<0.05）和 MetS 患者总胆固醇（TC）/高密度脂蛋白胆固醇（HDL-C）≥4.2（OR，4.44；95%CI，1.93 至 10.20；p<0.001）与 CA 独立相关。这两个指标在所有患者中均与血清 hs-CRP 升高和脂联素水平降低显著相关。
在调整动脉粥样硬化生物标志物后，MetS 与 CA 独立相关。MetS 中 TC/HDL-C≥4.2 和非 MetS 患者空腹血糖≥110mg/dl/糖尿病是 CA 的独立指标，提示 CA 的病理生理学可能存在差异。
