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OBJECTIVE - Metabolic syndrome (MetS) has been associated with increased prevalence of aortic valve calcium (AVC) and with increased progression of aortic stenosis. The purpose of this study was to determine whether MetS is associated with increased risks for the development of new ("incident") AVC or for progression of established AVC as assessed by CT.
RESEARCH DESIGN AND METHODS- The relationships of MetS or its components as well as of diabetes to risks for incident AVC or AVC progression were studied among participants with CT scans performed at baseline and at either year 2 or year 3 examinations in the Multi-Ethnic Study of Atherosclerosis (MESA).
RESULTS- Of 5,723 MESA participants meeting criteria for inclusion, 1,674 had MetS by Adult Treatment Panel III criteria, whereas 761 had diabetes. Among the 5,123 participants without baseline AVC, risks for incident AVC, adjusted for time between scans, age, sex, race/ethnicity, LDL cholesterol, lipid-lowering medications, and smoking, were increased significantly for MetS (odds ratio [OR] 1.67 [95% CI 1.21-2.31]) or diabetes (2.06 [1.39-3.06]). In addition, there was an increase in incident AVC risk with increasing number of MetS components. Similar results were found using the International Diabetes Federation MetS criteria. Among the 600 participants (10.5%) with baseline AVC, neither MetS nor diabetes was associated with AVC progression.
CONCLUSIONS- In the MESA cohort, MetS was associated with a significant increase in incident ("new") AVC, raising the possibility that MetS may be a potential therapeutic target to prevent AVC development. Diabetes 58:813-819, 2009
Metabolic syndrome (MetS) is a collection of clinical and laboratory abnormalities com- prised of central adiposity, hypertriglyceride- mia, low HDL cholesterol, elevated blood pressure, and/or impaired fasting glucose (1,2). Overall MetS prevalence has been estimated at -25% in Western populations (2,3) but is almost certainly increasing as a consequence of the worldwide epidemic of obesity (4,5). MetS is associated with both increased prevalence of coronary atherosclerosis (1,2,6,7) and increased risk for clinical cardiovascular events (8,9).
Cross-sectional U.S. data show that the prevalence of MetS increases with age (3), suggesting that MetS might contribute to risk for diseases with increased prevalence in the elderly. Examples of these diseases include both atherosclerosis (10) and calcific aortic valve disease (CAVD), which has a prevalence of 25% in those older than age...