Published Online
on April 24, 2006

A more recent version of this article appeared on May 2, 2006

This Article Full Text (PDF) All Versions of this Article: 113/17/2113    most recent CIRCULATIONAHA.105.598086v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Katz, R. Articles by O’Brien, K. D. Search for Related Content PubMed PubMed Citation Articles by Katz, R. Articles by O’Brien, K. D. Pubmed/NCBI databases Medline Plus Health Information Heart Valve Diseases Metabolic Syndrome Related Collections Valvular heart disease Type 2 diabetes Glucose intolerance CT and MRI Related Article

Submitted on November 8, 2005
Revised on February 9, 2006
Accepted on February 24, 2006

Features of the Metabolic Syndrome and Diabetes Mellitus as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis

Ronit Katz PhD, Nathan D. Wong PhD, Richard Kronmal PhD, Junichiro Takasu MD, PhD, David M. Shavelle MD, Jeffrey L. Probstfield MD, Alain G. Bertoni MD, MPH, Matthew J. Budoff MD, and Kevin D. O’Brien MD^*

From the University of Washington (R. Katz, R. Kronmal, J.L.P., K.D.O.), Seattle, Wash; University of California (N.D.W.), Irvine, Calif; Harbor-UCLA Research and Education Institute (J.T., D.M.S., M.J.B.), Torrance, Calif; and Wake Forest University Health Sciences (A.G.B.), Winston-Salem, NC.

Background--Calcific aortic valve disease is common in the elderly, is correlated with common cardiovascular risk factors, and is associated with increased cardiovascular event risk; however, whether metabolic syndrome is associated with an increased prevalence of aortic valve calcium (AVC) is not known.

Methods and Results--The prevalence of AVC, as assessed by computed tomography, was compared in 6780 Multi-Ethnic Study of Atherosclerosis (MESA) participants with metabolic syndrome (n=1550; National Cholesterol Education Program’s Adult Treatment Panel III [ATP III] criteria), diabetes mellitus (n=1016), or neither condition (n=4024). The prevalence of AVC for those with neither condition, metabolic syndrome, or diabetes mellitus was, respectively, 8%, 12%, and 17% in women (P<0.001) and 14%, 22%, and 24% in men (P<0.001). Compared with those with neither condition, the adjusted relative risks for the presence of AVC were 1.45 (95% CI 1.11 to 1.90) for metabolic syndrome and 2.12 (95% CI 1.54 to 2.92) for diabetes mellitus in women and 1.70 (95% CI 1.32 to 2.19) for metabolic syndrome and 1.73 (95% CI 1.33 to 2.25) for diabetes mellitus in men. There was a graded, linear relationship between AVC prevalence and the number of metabolic syndrome components in both women and men (both P<0.001). Similar results were obtained when the International Diabetes Federation metabolic syndrome definition was used.

Conclusions--In the MESA cohort, the metabolic syndrome and diabetes mellitus are associated with increased risk of AVC, and AVC prevalence is increased with increasing number of metabolic syndrome components.

Key words: calcium • diabetes mellitus • tomography • valves • metabolic syndrome

Related Article:

Issue Highlights
Circulation 2006 113: 2031. [Full Text]

This article has been cited by other articles:

				D. S. Owens, R. Katz, E. Johnson, D. M. Shavelle, J. L. Probstfield, J. Takasu, J. R. Crouse, J. J. Carr, R. Kronmal, M. J. Budoff, et al. Interaction of Age With Lipoproteins as Predictors of Aortic Valve Calcification in the Multi-Ethnic Study of Atherosclerosis Arch Intern Med, June 9, 2008; 168(11): 1200 - 1207. [Abstract] [Full Text] [PDF]

				Y. Bosse, P. Mathieu, and P. Pibarot Genomics: The Next Step to Elucidate the Etiology of Calcific Aortic Valve Stenosis J. Am. Coll. Cardiol., April 8, 2008; 51(14): 1327 - 1336. [Abstract] [Full Text] [PDF]

				J. H. Ix, R. Katz, B. Kestenbaum, L. F. Fried, H. Kramer, C. Stehman-Breen, and M. G. Shlipak Association of Mild to Moderate Kidney Dysfunction and Coronary Calcification J. Am. Soc. Nephrol., March 1, 2008; 19(3): 579 - 585. [Abstract] [Full Text] [PDF]

				D. A. Towler Vascular Calcification: A Perspective On An Imminent Disease Epidemic IBMS BoneKEy, February 1, 2008; 5(2): 41 - 58. [Abstract] [Full Text] [PDF]

				Z. Al-Aly, J.-S. Shao, C.-F. Lai, E. Huang, J. Cai, A. Behrmann, S.-L. Cheng, and D. A. Towler Aortic Msx2-Wnt Calcification Cascade Is Regulated by TNF-{alpha} Dependent Signals in Diabetic Ldlr / Mice Arterioscler. Thromb. Vasc. Biol., December 1, 2007; 27(12): 2589 - 2596. [Abstract] [Full Text] [PDF]

				K.J. Grande-Allen, N. Osman, M.L. Ballinger, H. Dadlani, S. Marasco, and P.J. Little Glycosaminoglycan synthesis and structure as targets for the prevention of calcific aortic valve disease Cardiovasc Res, October 1, 2007; 76(1): 19 - 28. [Abstract] [Full Text] [PDF]

				J. H. Ix, G. M. Chertow, M. G. Shlipak, V. M. Brandenburg, M. Ketteler, and M. A. Whooley Association of Fetuin-A With Mitral Annular Calcification and Aortic Stenosis Among Persons With Coronary Heart Disease: Data From the Heart and Soul Study Circulation, May 15, 2007; 115(19): 2533 - 2539. [Abstract] [Full Text] [PDF]

				D. A. Towler Imaging Aortic Matrix Metabolism: Mirabile Visu! Circulation, January 23, 2007; 115(3): 297 - 299. [Full Text] [PDF]

				K. D. O'Brien Pathogenesis of Calcific Aortic Valve Disease: A Disease Process Comes of Age (and a Good Deal More) Arterioscler. Thromb. Vasc. Biol., August 1, 2006; 26(8): 1721 - 1728. [Abstract] [Full Text] [PDF]