Abstract 4048: Independent and Additive Influence of Metabolic Syndrome and Diabetes Mellitus on Atherosclerosis: Observations from the Dallas Heart Study
Background: While diabetes mellitus (DM) may be considered a “coronary disease equivalent,” observations from the NHANES project suggest that the incremental atherosclerotic risk associated with DM is limited to those individuals with DM who concomitantly have the metabolic syndrome (MS).
Methods: Using data from the Dallas Heart Study, a population-based probability sample with 2735 participants age 30–65 who had coronary CT and aorta MRI scans, we analyzed the individual and joint associations between MS only (n=697), DM only (n=53), or both MS and DM (n=246) with prevalent coronary artery calcium (CAC; Agatston score>10) and abdominal aortic plaque (AAP; present/absent).
Results: As shown in the Figure⇓, compared with subjects with neither MS or DM, there was a stepwise increase in the prevalence of CAC and AAP in those with MS only, DM only, and both MS and DM (p<0.01 for all). CAC and AAP were more common in those with both DM and MS compared with those with either abnormality alone (p<0.0001 for both). No DM-by-MS interaction was evident for either CAC (interaction p=0.63) or AAP (interaction p=0.52), demonstrating the independent association of DM and MS with atherosclerosis.
Conclusions: Contrary to prior observations, these data suggest that DM and MS are individually and additively associated with increased prevalence of atherosclerosis, with the highest observed CAC and AAP prevalence in subjects with both DM and MS.