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Blood pressure and fasting plasma glucose rather than metabolic syndrome predict coronary artery calcium progression: the Rancho Bernardo Study.

Kramer CK, von Mühlen D, Gross JL, Laughlin GA, Barrett-Connor E - Diabetes Care (2008)

Bottom Line: Progression was defined as an increase in total CAC volume score > or =2.5 mm(3).In logistic regression analyses adjusted for age, sex, smoking status, and LDL cholesterol, neither WHO-nor ATP-III-defined metabolic syndrome predicted CAC progression.Fasting blood glucose (>100 mg/dl) was an independent predictor of CAC progression, but only for the 118 participants younger than age 65 years (2.3 [1.01-5.5], P = 0.04).

View Article: PubMed Central - PubMed

Affiliation: Division of Epidemiology, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA.

ABSTRACT

Objective: To examine the association of the metabolic syndrome, defined by World Health Organization (WHO) and Adult Treatment Panel III (ATP-III) criteria, and its components with coronary artery calcium (CAC) progression.

Research design and methods: Participants were 338 older community-dwelling men and women without known heart disease who had measurements of heart disease risk factors and CAC at two clinic visits within an average interval of 4.5 years. Progression was defined as an increase in total CAC volume score > or =2.5 mm(3).

Results: At baseline, mean age was 67.6 years; metabolic syndrome was present in 15.1% by WHO criteria and in 11.8% by ATP-III criteria, and 5.3% met both criteria. Participants with WHO-defined metabolic syndrome had a greater change in total CAC volume score than those without (P = 0.001). There was no significant difference in CAC volume change by ATP-III-defined metabolic syndrome status (P = 0.69). Overall, 46.4% of participants were CAC progressors. In logistic regression analyses adjusted for age, sex, smoking status, and LDL cholesterol, neither WHO-nor ATP-III-defined metabolic syndrome predicted CAC progression. Among metabolic syndrome components, only hypertension was independently associated with CAC progression (odds ratio 2.11 [95% CI 1.33-3.3], P = 0.002). Fasting blood glucose (>100 mg/dl) was an independent predictor of CAC progression, but only for the 118 participants younger than age 65 years (2.3 [1.01-5.5], P = 0.04).

Conclusions: In older adults without known heart disease, blood pressure levels and fasting plasma glucose were better independent determinants of CAC progression than metabolic syndrome itself.

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Related in: MedlinePlus

Odds ratios for metabolic syndrome and metabolic syndrome components as predictors for CAC progression adjusted for age, sex, LDL cholesterol, and smoking habit. A: Metabolic syndrome by WHO criteria and components. B: Metabolic syndrome by ATP-III criteria and components.
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f1: Odds ratios for metabolic syndrome and metabolic syndrome components as predictors for CAC progression adjusted for age, sex, LDL cholesterol, and smoking habit. A: Metabolic syndrome by WHO criteria and components. B: Metabolic syndrome by ATP-III criteria and components.

Mentions: Multivariate linear regression was used to assess the association between CAC volume score change and individual components of metabolic syndrome as continuous variables adjusting for age, sex, LDL cholesterol, and smoking status. Only blood pressure (standardized β-coefficient: systolic blood pressure 0.19, P = 0.001; diastolic blood pressure 0.14, P = 0.007) and FPG (standardized β-coefficient 0.16, P = 0.02) were independently associated with CAC progression (Table 3). The same multivariable model was used to assess the association between metabolic syndrome by WHO or ATP-III criteria with categorical (yes/no) progression of CAC. Metabolic syndrome neither by WHO nor by ATP-III was associated with CAC progression in models adjusted for age, sex, LDL cholesterol, and smoking status (Fig. 1). Of the individual components, only hypertension was associated with CAC progression (odds ratio [OR] 2.11 [95% CI 1.33–3.3], P = 0.002) (Fig. 1). Moreover, CAC volume changes were greater for higher categories of systolic blood pressure (CAC volume change [square root]: systolic blood pressure <120 mmHg, 1.8 ± 2.2; 120–140 mmHg, 2.4 ± 2.8; 140–160 mmHg, 3.1 ± 3.2; >160 mmHg, 4.1 ± 3.0; P = 0.003 for linear trend) in models adjusting for the same covariates.


Blood pressure and fasting plasma glucose rather than metabolic syndrome predict coronary artery calcium progression: the Rancho Bernardo Study.

Kramer CK, von Mühlen D, Gross JL, Laughlin GA, Barrett-Connor E - Diabetes Care (2008)

Odds ratios for metabolic syndrome and metabolic syndrome components as predictors for CAC progression adjusted for age, sex, LDL cholesterol, and smoking habit. A: Metabolic syndrome by WHO criteria and components. B: Metabolic syndrome by ATP-III criteria and components.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2606850&req=5

f1: Odds ratios for metabolic syndrome and metabolic syndrome components as predictors for CAC progression adjusted for age, sex, LDL cholesterol, and smoking habit. A: Metabolic syndrome by WHO criteria and components. B: Metabolic syndrome by ATP-III criteria and components.
Mentions: Multivariate linear regression was used to assess the association between CAC volume score change and individual components of metabolic syndrome as continuous variables adjusting for age, sex, LDL cholesterol, and smoking status. Only blood pressure (standardized β-coefficient: systolic blood pressure 0.19, P = 0.001; diastolic blood pressure 0.14, P = 0.007) and FPG (standardized β-coefficient 0.16, P = 0.02) were independently associated with CAC progression (Table 3). The same multivariable model was used to assess the association between metabolic syndrome by WHO or ATP-III criteria with categorical (yes/no) progression of CAC. Metabolic syndrome neither by WHO nor by ATP-III was associated with CAC progression in models adjusted for age, sex, LDL cholesterol, and smoking status (Fig. 1). Of the individual components, only hypertension was associated with CAC progression (odds ratio [OR] 2.11 [95% CI 1.33–3.3], P = 0.002) (Fig. 1). Moreover, CAC volume changes were greater for higher categories of systolic blood pressure (CAC volume change [square root]: systolic blood pressure <120 mmHg, 1.8 ± 2.2; 120–140 mmHg, 2.4 ± 2.8; 140–160 mmHg, 3.1 ± 3.2; >160 mmHg, 4.1 ± 3.0; P = 0.003 for linear trend) in models adjusting for the same covariates.

Bottom Line: Progression was defined as an increase in total CAC volume score > or =2.5 mm(3).In logistic regression analyses adjusted for age, sex, smoking status, and LDL cholesterol, neither WHO-nor ATP-III-defined metabolic syndrome predicted CAC progression.Fasting blood glucose (>100 mg/dl) was an independent predictor of CAC progression, but only for the 118 participants younger than age 65 years (2.3 [1.01-5.5], P = 0.04).

View Article: PubMed Central - PubMed

Affiliation: Division of Epidemiology, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California, USA.

ABSTRACT

Objective: To examine the association of the metabolic syndrome, defined by World Health Organization (WHO) and Adult Treatment Panel III (ATP-III) criteria, and its components with coronary artery calcium (CAC) progression.

Research design and methods: Participants were 338 older community-dwelling men and women without known heart disease who had measurements of heart disease risk factors and CAC at two clinic visits within an average interval of 4.5 years. Progression was defined as an increase in total CAC volume score > or =2.5 mm(3).

Results: At baseline, mean age was 67.6 years; metabolic syndrome was present in 15.1% by WHO criteria and in 11.8% by ATP-III criteria, and 5.3% met both criteria. Participants with WHO-defined metabolic syndrome had a greater change in total CAC volume score than those without (P = 0.001). There was no significant difference in CAC volume change by ATP-III-defined metabolic syndrome status (P = 0.69). Overall, 46.4% of participants were CAC progressors. In logistic regression analyses adjusted for age, sex, smoking status, and LDL cholesterol, neither WHO-nor ATP-III-defined metabolic syndrome predicted CAC progression. Among metabolic syndrome components, only hypertension was independently associated with CAC progression (odds ratio 2.11 [95% CI 1.33-3.3], P = 0.002). Fasting blood glucose (>100 mg/dl) was an independent predictor of CAC progression, but only for the 118 participants younger than age 65 years (2.3 [1.01-5.5], P = 0.04).

Conclusions: In older adults without known heart disease, blood pressure levels and fasting plasma glucose were better independent determinants of CAC progression than metabolic syndrome itself.

Show MeSH
Related in: MedlinePlus