Abstract P228: Distribution of Multisite Atherosclerosis in Persons with Metabolic Syndrome & Diabetes: The Multi-Ethnic Study of Atherosclerosis
Background: The extent of atherosclerosis across multiple vascular beds in persons with metabolic syndrome (Mets) and diabetes (DM) has not been documented. We hypothesized a greater presence/extent of multisite atherosclerosis in MetS and DM, vs. neither.
Methods: We analyzed four vascular beds (coronary (CA), abdominal aorta (AA), carotid, peripheral vascular) in subjects without cardiovascular disease from the Multi-Ethnic Study of Atherosclerosis, who had complete data on these measures. Multisite atherosclerosis was defined as the presence/extent of CA calcium, AA calcium, carotid intimal medial thickness (disease ≥1mm) and borderline/abnormal (<1 or ≥1.3) ankle brachial index. We then created a composite score summing the continuous gender-stratified standardized z-scores for each measure. ANOVA compared least squares means across disease states; logistic regression gave odds of being in the top quartile of the composite score distribution. We adjusted for non-MetS risk factors (age, gender, ethnicity, smoking, LDL-C, lipid medications, family history).
Results: Of 1,771 subjects (mean age 64, 50% male, 40% Caucasian, 25% Hispanic, 21% African American, 14% Chinese), 25% had MetS and 13% DM. Persons with DM or Mets had a greater number of sites positive for atherosclerosis (figure). Adjusted mean composite scores increased across disease groups (neither disease 0.24, MetS 0.88, DM 1.38, p<0.001 between groups). Adjusted logistic regression showed that the odds of being in the top quartile of the composite score were higher for those with DM OR=4.42 [2.21-8.83] p<0.001 and MetS OR=2.72 [1.63-4.56] p<0.001, vs. neither condition.
Conclusions: Those with MetS or DM have an increased prevalence and extent of multisite atherosclerosis. Whether disease in one vascular bed should prompt further evaluation, and how this relates to future CVD events, requires further investigation. Our findings support the concept that atherosclerosis in those with MetS or DM is more likely to be systemic vs. site-specific.
Author Disclosures: M.A. Evans: None. M.A. Allison: None. A.G. Bertoni: None. M.J. Budoff: G. Consultant/Advisory Board; Modest; General Electric. M.H. Criqui: None. S. Malik: None. P. Ouyang: None. J.F. Polak: None. N.D. Wong: B. Research Grant; Significant; Bristol Myers Squibb, Gilead. G. Consultant/Advisory Board; Significant; Re-Engineering Healthcare.
- © 2014 by American Heart Association, Inc.