Abstract 14214: The Association of Multiple Phenotypic Presentations of Metabolic Syndrome with Subclinical Atherosclerosis in the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Background: Significant phenotypic variation exists among individuals classified as having metabolic syndrome (MetSyn). Moreover, not all individuals with MetSyn are obese, and not all obese individuals have MetSyn. Whether the prevalence of subclinical atherosclerosis varies by the phenotypic presentation of MetSyn is unclear.
Methods: We studied 2,882 CARDIA participants with complete data on MetSyn components who underwent a coronary artery calcium (CAC) scan during the Year 20 (2005-6) follow-up exam in CARDIA. MetSyn was defined using the AHA/NHLBI/International Diabetes Federation harmonized criteria. Participants were classified into 1 of 4 groups stratified by gender: 1) non-centrally obese without MetSyn, 2) centrally obese without MetSyn, 3) non-centrally obese with MetSyn, and 4) centrally obese with MetSyn. Central obesity was defined as >88 cm in women and >102 cm in men. The presence of CAC was determined using cardiac computed tomography. Images were interpreted in a centralized core lab. To determine the cross-sectional association between the 4 phenotypic groups and the presence of CAC, we performed multivariable logistic regression, separately in men and women, adjusting for age, race, education, smoking status, alcohol use, physical activity, and economic deprivation.
Results: Mean age was 45+4 years, 57% were women, and 56% were white; 27% of men and 21% of women met criteria for MetSyn. The overall prevalence of CAC was 29% in men and 11% in women. Compared to those who were non-obese without MetSyn, obese individuals with MetSyn had the highest odds of CAC in men; however, in women, both obese and non-obese individuals with MetSyn had an increased risk of having CAC, with the highest odds of CAC in non-obese women (Table).
Conclusion: These results, if confirmed in populations with larger numbers of non-obese individuals with MetSyn, suggest that the prevalence of CAC is not uniform across varying phenotypic presentations of MetSyn.
- © 2011 by American Heart Association, Inc.