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Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Metabolic syndrome and high-sensitivity C-reactive protein co-modify the risk of coronary artery calcification
Li-Yu Chen1, Yen-Kung Chen2,3, Vy-Khanh Nguyen4,5
1Department of Family Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Insights
Metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hs-CRP) both increase coronary artery calcification (CAC) risk. The combination of MetS and high hs-CRP significantly elevates CAC odds, highlighting their combined impact on cardiovascular health.
Area of Science:
- Cardiology
- Metabolic Health
- Inflammation Research
Background:
- Coronary artery calcification (CAC) signifies subclinical atherosclerosis and strongly correlates with coronary artery disease (CAD).
- Metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hs-CRP) are individually linked to CAC.
- The combined effect of MetS and hs-CRP on CAC remains incompletely understood.
Purpose of the Study:
- To investigate the independent and combined associations of Metabolic Syndrome (MetS) and high-sensitivity C-reactive protein (hs-CRP) with Coronary Artery Calcification (CAC).
- To determine the relative contributions of MetS and hs-CRP to the presence and severity of CAC.
Main Methods:
- A cross-sectional study involving 1948 adults undergoing health checkups and computed tomography for coronary calcium scoring.
- Participants were stratified based on MetS status and hs-CRP levels (<0.3 vs. ≥0.3 mg/dL).
- Multivariate logistic regression analyses were employed to assess associations, adjusting for relevant clinical covariates.
Main Results:
- The group with both MetS and high hs-CRP exhibited the highest Agatston scores, indicating severe CAC.
- CAC prevalence increased progressively with the number of MetS components (44.5% to 100%).
- High fasting glucose, hypertension, and high waist circumference were significantly associated with CAC. Elevated hs-CRP independently predicted CAC, with a dose-response relationship observed. The highest odds of CAC were found in individuals with both MetS and high hs-CRP (aOR, 2.392).
Conclusions:
- Metabolic syndrome demonstrates a more substantial association with coronary artery calcification than hs-CRP alone.
- High-sensitivity C-reactive protein confers an additional, albeit modest, incremental risk for CAC in the presence of MetS.
- The combined presence of MetS and elevated hs-CRP significantly amplifies the risk of coronary artery calcification.
Background:
Coronary artery calcification (CAC) is a marker of subclinical atherosclerosis and is strongly associated with coronary artery disease (CAD). Metabolic syndrome (MetS) and high-sensitivity C-reactive protein (hs-CRP), an inflammatory marker, have each been linked to CAC, but their combined influence remains unclear.
Methods:
This cross-sectional study included 1948 adults undergoing health checkups and coronary calcium scoring via computed tomography. Participants were grouped by MetS status and hs-CRP levels (<0.3 vs. ≥0.3 mg/dL). Multivariate logistic regression analysis was used to evaluate associations between MetS, hs-CRP, and CAC, adjusting for age, sex, and clinical variables.
Results:
The cohort (mean age, 49 years; 78% male) was categorized into four groups: MetS(-)/low hs-CRP (74%), MetS(-)/high hs-CRP (10%), MetS(+)/low hs-CRP (12%), and MetS(+)/high hs-CRP (5%). The MetS(+)/high hs-CRP group had the highest Agatston score. CAC prevalence increased with the number of MetS components (from 44.5% to 100%). Among MetS components, high fasting glucose [adjusted odds ratio [aOR], 1.973; 95% confidence interval [CI], 1.526-2.551], hypertension (aOR, 1.674; 95% CI, 1.324-2.117), and high waist circumference (aOR, 1.492; 95% CI, 1.187-1.877) had the strongest associations with CAC. Elevated hs-CRP was independently associated with CAC (aOR, 1.631; 95% CI, 1.205-2.208), with a dose-response trend per 1 mg/dL increase (aOR, 1.360; 95% CI, 0.990-1.869). Compared to the MetS(-)/low hs-CRP group, the odds of CAC were highest in the MetS(+)/high hs-CRP group (aOR, 2.392; 95% CI, 1.470-3.891), followed by MetS(+)/low hs-CRP (aOR, 1.996; 95% CI, 1.426-2.795), and MetS(-)/high hs-CRP (aOR, 1.538; 95% CI, 1.067-2.218).
Conclusions:
MetS showed a stronger association with CAC than hs-CRP, while hs-CRP appeared to confer a modest incremental association.
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