Won Ki-Bum, Chang Hyuk-Jae, Sung Jimin, Shin Sanghoon, Cho In-Jeong, Shim Chi-Young, Hong Geu-Ru, Kim Young Jin, Choi Byung-Wook, Chung Namsik
Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
BMC Cardiovasc Disord. 2014 Aug 20;14:105. doi: 10.1186/1471-2261-14-105.
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.
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.
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.
MetS was independently associated with the presence and severity of CAD only in the non-diabetic subjects among the symptomatic Korean population.
代谢综合征（MetS）与糖尿病和冠状动脉疾病（CAD）风险增加相关。尽管将已确诊的糖尿病纳入MetS存在争议，但在亚洲人群中，MetS与CAD之间根据糖尿病状态的关联尚未阐明。
我们在2869名接受心脏计算机断层血管造影的有症状韩国受试者中，根据糖尿病状态，使用包括任何斑块、阻塞性斑块和冠状动脉钙化评分（CACS）>100等参数评估MetS与CAD之间的关联。
糖尿病受试者中MetS的患病率显著高于非糖尿病受试者（69%对34%，P<0.001）。糖尿病受试者中任何斑块的发生率（64%对43%，P<0.001）、阻塞性斑块的发生率（26%对13%，P = 0.006）以及CACS>100的发生率（23%对12%，P = 0.012）均显著高于非糖尿病受试者。在MetS各组分中，非糖尿病受试者中高密度脂蛋白水平降低与任何斑块（优势比[OR] 1.35）、阻塞性斑块（OR 1.55）和CACS>100（OR 1.57）显著相关（P均<0.01）。然而，在糖尿病受试者中，没有一个MetS组分与所有参数相关。多因素回归分析显示，仅在非糖尿病受试者中，MetS和MetS组分数量（MetSN）分别与任何斑块（MetS：OR 1.55，P<0.001；MetSN：OR 1.22，P<0.001）、阻塞性斑块（MetS：OR 1.52，P = 0.003；MetSN：OR 1.25，P<0.001）和CACS>100（MetS：OR 1.46，P = 0.015；MetSN：OR 1.21，P = 0.004）独立相关。
在有症状的韩国人群中，仅在非糖尿病受试者中，MetS与CAD的存在和严重程度独立相关。
