Ullah Aftab, Jan Asif, Kareem Hasan Naeem, Babaresh Wahby Mohammed Ahmed, Rahim Abdur, Ali Syed Shaukat, Shah Waheed Ali, Hajwal Salim K, Hermis Alaa Hamza, Jawad Mustafa Kareem, Salman Sajjad Sadeq, Ajel Murtadha Abdulridha, Alsuwayidi Fatimah Saleh, Alobaidan Fadhilah N, Kadhem Ameer Hasan
Department of Pharmacy, University of Peshawar, Peshawar, Pakistan.
Department of Pharmacy, Abasyn University Peshawar, Peshawar, Pakistan.
Clin Cardiol. 2025 Jun;48(6):e70156. doi: 10.1002/clc.70156.
Metabolic syndrome (MetS) is a recognized risk factor for coronary artery calcification (CAC), a subclinical marker of atherosclerosis associated with elevated cardiovascular risk. However, the prevalence and determinants of CAC in individuals with MetS have not been comprehensively synthesized. This systematic review and meta-analysis aimed to estimate the pooled prevalence of CAC and identify associated factors among adults with MetS.
A comprehensive search was conducted in PubMed, LILACS, Web of Science, Embase, Scopus, AJOL, and gray literature through December 2024, following PRISMA 2020 guidelines. Eligible studies included adults (≥ 18 years) with MetS, defined by established criteria, and reported CAC scores via validated CT imaging techniques. Observational studies and RCTs were included. Study quality was assessed using the Joanna Briggs Institute checklist. Pooled estimates were derived using a random-effects model, and heterogeneity was assessed with the I statistic.
In total, 17 studies comprising 20 745 individuals were included. The pooled prevalence of CAC in adults with MetS was 39.8% (95% CI: 28.4%-52.5%), with wide variation across study design, geography, and imaging modality. Males had a higher CAC prevalence (RR: 2.00), and MetS was linked to increased CAC scores (SMD: 0.10) and odds of calcification (OR: 1.34-1.50). Subgroup analyses showed variability by region and CT modality. High CAC scores were associated with elevated cardiovascular event rates.
CAC affects ~40% of adults with MetS and is associated with higher cardiovascular risk. These findings support the integration of CAC screening in MetS management strategies.
代谢综合征（MetS）是冠状动脉钙化（CAC）的公认危险因素，冠状动脉钙化是动脉粥样硬化的一种亚临床标志物，与心血管风险升高相关。然而，MetS患者中CAC的患病率和决定因素尚未得到全面综合。本系统评价和荟萃分析旨在估计成人MetS患者中CAC的合并患病率，并确定相关因素。
按照PRISMA 2020指南，截至2024年12月在PubMed、LILACS、科学网、Embase、Scopus、AJOL和灰色文献中进行了全面检索。符合条件的研究包括年龄≥18岁的MetS成人患者，根据既定标准定义，并通过经过验证的CT成像技术报告CAC评分。纳入观察性研究和随机对照试验。使用乔安娜·布里格斯研究所检查表评估研究质量。采用随机效应模型得出合并估计值，并用I统计量评估异质性。
共纳入17项研究，涉及20745名个体。成人MetS患者中CAC的合并患病率为39.8%（95%CI：28.4%-52.5%），不同研究设计、地理位置和成像方式之间存在很大差异。男性的CAC患病率较高（RR：2.00），MetS与CAC评分增加（SMD：0.10）和钙化几率增加（OR：1.34-1.50）相关。亚组分析显示，不同地区和CT方式存在差异。高CAC评分与心血管事件发生率升高相关。
CAC影响约40%的MetS成人患者，并与较高的心血管风险相关。这些发现支持将CAC筛查纳入MetS管理策略。
