Agreement of two metabolic syndrome definitions and their association with subclinical atherosclerosis

Multi-ethnic study of atherosclerosis cross sectional study

Dhananjay Vaidya, Moyses Szklo, Jingzhong Ding, Russell Tracy, Kiang Liu, Mohammed Saad, Pamela Ouyang

Research output: Contribution to journalArticle

Abstract

Background: The metabolic syndrome (MetS) is a cluster of abnormalities that increases cardiovascular risk. Two different current clinical definitions of MetS, World Health Organization (WHO) and National Cholesterol Education Program (NCEP) Adult Treatment Panel 3 (ATPIII) may differ in association with the atherosclerotic process. We quantified the agreement between the WHO and NCEP definitions and their association with subclinical atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We analyzed 2601 Caucasian-Americans (C), 800 Chinese-Americans (Ch), 1864 African-Americans (A), and 1483 Hispanic-Americans (H) with complete data for MetS classification from the baseline of the population-based study MESA. Coronary artery calcification (CAC, Agatston score) was quantified by electron beam or helical computed tomography (CT), and intimal-medial thickness of internal and common carotid arteries (IIMT, CIMT) by B-mode ultrasound. Results: The percentage positive agreement differed by ethnicity (Men: C, 65%; Ch, 58%; B, 67%; H, 74%. Women: C, 58%; Ch, 67%; A, 69%; H, 71%; P <.001). Fasting insulin measurement added to the association of the NCEP definition with presence of CAC (P <.001) and CIMT (P <.001, men; P <.002, women), while the waist-hip ratio metric of obesity adds to the association with CIMT (P <.001, men; .003, women). The NCEP threshold for low HDL was associated with CIMT independent of the WHO definition (men, P = .035; women, P = .043). These independent associations did not differ by ethnicity. Conclusion: Metabolic risk factors that differ between the NCEP and WHO MetS definitions are useful in combination to assess the presence of subclinical atherosclerosis.

Original languageEnglish (US)
Pages (from-to)343-352
Number of pages10
JournalMetabolic Syndrome and Related Disorders
Volume5
Issue number4
DOIs
StatePublished - Dec 1 2007

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Atherosclerosis
Cross-Sectional Studies
Cholesterol
Asian Americans
Education
Cardiovascular Abnormalities
X Ray Computed Tomography
Waist-Hip Ratio
Spiral Computed Tomography
Common Carotid Artery
Hispanic Americans
African Americans
Fasting
Coronary Vessels
Obesity
Insulin
Population
Therapeutics

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

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title = "Agreement of two metabolic syndrome definitions and their association with subclinical atherosclerosis: Multi-ethnic study of atherosclerosis cross sectional study",
abstract = "Background: The metabolic syndrome (MetS) is a cluster of abnormalities that increases cardiovascular risk. Two different current clinical definitions of MetS, World Health Organization (WHO) and National Cholesterol Education Program (NCEP) Adult Treatment Panel 3 (ATPIII) may differ in association with the atherosclerotic process. We quantified the agreement between the WHO and NCEP definitions and their association with subclinical atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We analyzed 2601 Caucasian-Americans (C), 800 Chinese-Americans (Ch), 1864 African-Americans (A), and 1483 Hispanic-Americans (H) with complete data for MetS classification from the baseline of the population-based study MESA. Coronary artery calcification (CAC, Agatston score) was quantified by electron beam or helical computed tomography (CT), and intimal-medial thickness of internal and common carotid arteries (IIMT, CIMT) by B-mode ultrasound. Results: The percentage positive agreement differed by ethnicity (Men: C, 65{\%}; Ch, 58{\%}; B, 67{\%}; H, 74{\%}. Women: C, 58{\%}; Ch, 67{\%}; A, 69{\%}; H, 71{\%}; P <.001). Fasting insulin measurement added to the association of the NCEP definition with presence of CAC (P <.001) and CIMT (P <.001, men; P <.002, women), while the waist-hip ratio metric of obesity adds to the association with CIMT (P <.001, men; .003, women). The NCEP threshold for low HDL was associated with CIMT independent of the WHO definition (men, P = .035; women, P = .043). These independent associations did not differ by ethnicity. Conclusion: Metabolic risk factors that differ between the NCEP and WHO MetS definitions are useful in combination to assess the presence of subclinical atherosclerosis.",
author = "Dhananjay Vaidya and Moyses Szklo and Jingzhong Ding and Russell Tracy and Kiang Liu and Mohammed Saad and Pamela Ouyang",
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T1 - Agreement of two metabolic syndrome definitions and their association with subclinical atherosclerosis

T2 - Multi-ethnic study of atherosclerosis cross sectional study

AU - Vaidya, Dhananjay

AU - Szklo, Moyses

AU - Ding, Jingzhong

AU - Tracy, Russell

AU - Liu, Kiang

AU - Saad, Mohammed

AU - Ouyang, Pamela

PY - 2007/12/1

Y1 - 2007/12/1

N2 - Background: The metabolic syndrome (MetS) is a cluster of abnormalities that increases cardiovascular risk. Two different current clinical definitions of MetS, World Health Organization (WHO) and National Cholesterol Education Program (NCEP) Adult Treatment Panel 3 (ATPIII) may differ in association with the atherosclerotic process. We quantified the agreement between the WHO and NCEP definitions and their association with subclinical atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We analyzed 2601 Caucasian-Americans (C), 800 Chinese-Americans (Ch), 1864 African-Americans (A), and 1483 Hispanic-Americans (H) with complete data for MetS classification from the baseline of the population-based study MESA. Coronary artery calcification (CAC, Agatston score) was quantified by electron beam or helical computed tomography (CT), and intimal-medial thickness of internal and common carotid arteries (IIMT, CIMT) by B-mode ultrasound. Results: The percentage positive agreement differed by ethnicity (Men: C, 65%; Ch, 58%; B, 67%; H, 74%. Women: C, 58%; Ch, 67%; A, 69%; H, 71%; P <.001). Fasting insulin measurement added to the association of the NCEP definition with presence of CAC (P <.001) and CIMT (P <.001, men; P <.002, women), while the waist-hip ratio metric of obesity adds to the association with CIMT (P <.001, men; .003, women). The NCEP threshold for low HDL was associated with CIMT independent of the WHO definition (men, P = .035; women, P = .043). These independent associations did not differ by ethnicity. Conclusion: Metabolic risk factors that differ between the NCEP and WHO MetS definitions are useful in combination to assess the presence of subclinical atherosclerosis.

AB - Background: The metabolic syndrome (MetS) is a cluster of abnormalities that increases cardiovascular risk. Two different current clinical definitions of MetS, World Health Organization (WHO) and National Cholesterol Education Program (NCEP) Adult Treatment Panel 3 (ATPIII) may differ in association with the atherosclerotic process. We quantified the agreement between the WHO and NCEP definitions and their association with subclinical atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: We analyzed 2601 Caucasian-Americans (C), 800 Chinese-Americans (Ch), 1864 African-Americans (A), and 1483 Hispanic-Americans (H) with complete data for MetS classification from the baseline of the population-based study MESA. Coronary artery calcification (CAC, Agatston score) was quantified by electron beam or helical computed tomography (CT), and intimal-medial thickness of internal and common carotid arteries (IIMT, CIMT) by B-mode ultrasound. Results: The percentage positive agreement differed by ethnicity (Men: C, 65%; Ch, 58%; B, 67%; H, 74%. Women: C, 58%; Ch, 67%; A, 69%; H, 71%; P <.001). Fasting insulin measurement added to the association of the NCEP definition with presence of CAC (P <.001) and CIMT (P <.001, men; P <.002, women), while the waist-hip ratio metric of obesity adds to the association with CIMT (P <.001, men; .003, women). The NCEP threshold for low HDL was associated with CIMT independent of the WHO definition (men, P = .035; women, P = .043). These independent associations did not differ by ethnicity. Conclusion: Metabolic risk factors that differ between the NCEP and WHO MetS definitions are useful in combination to assess the presence of subclinical atherosclerosis.

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