PURPOSE: Diabetes mellitus (DM) is considered a coronary risk equivalent, while the independent significance of the metabolic syndrome (MetS) is controversial. The purpose of this study was to determine if the likelihood of CAD is affected by an interaction between DM and MetS.
METHODS: This study included 600 patients with no known history of CAD who presented for elective cardiac catheterization, including 342 men (mean age 60+11 years) and 258 women (mean age 63+10 years). Patients were evaluated for the presence or absence of MetS using the NCEP-ATP III criteria. DM was defined as fasting blood glucose >126 or on DM treatment; CAD was defined as the presence of at least 70% stenosis in one of the 3 major coronary vessels or one of their significant branches, or 50% stenosis in the left main coronary artery. Relationships were assessed univariately using the Pearson chi-square test and using a multivariate logistic regression analysis.
RESULTS: MetS was present in 286/600 patients. DM was present in 169 patients. Univariate analysis showed that the MetS+/DM+ group had a significantly greater occurrence of CAD than the MetS+/DM− group (P<.01), the MetS−/DM+ group (P<.04), or the MetS−/DM− group (p<.01). Multivariate logistic regression analysis using MetS and DM confirmed that the interaction of DM and MetS significantly increased the likelihood of CAD (OR 2.25, 95% CI 1.10–4.56, p=0.026).
CONCLUSION: The interaction of MetS and DM is more important than either factor alone for predicting CAD.
CLINICAL IMPLICATIONS: The interaction of MetS and DM is more important than either factor alone for predicting CAD.
DISCLOSURE: Susana Ayyanathan, No Financial Disclosure Information; No Product/Research Disclosure Information