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Alshammary AF, Alharbi KK, Alshehri NJ, Vennu V, Ali Khan I. Metabolic Syndrome and Coronary Artery Disease Risk: A Meta-Analysis of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041773. [PMID: 33670349 PMCID: PMC7918238 DOI: 10.3390/ijerph18041773] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/12/2022]
Abstract
Although numerous studies have described the link between metabolic syndrome (MetS) and Coronary Artery Disease (CAD), no meta-analysis has been carried out on this relationship. Thus, the present study intended to address this limitation. A systematic search was carried out using electronic databases, such as PubMed, CINAHL Plus, Medline, and Web of Science. A sum of 10 studies (n = 9327) was incorporated in the meta-analysis. Compared with non-MetS, MetS was significantly associated with high CAD risk (OR = 4.03, 95% CI = 3.56–4.56). The MetS components were also significantly correlated with high CAD risk (OR = 3.72, 95% CI = 3.22–4.40). The presence of two (OR = 3.93, 95% CI = 2.81–5.49), three (OR = 4.09, 95% CI = 2.85–5.86), four (OR = 4.04, 95% CI = 2.83–5.78), or all five MetS components (OR = 3.92, 95% CI = 3.11–4.93), were significantly associated with a high risk of CAD. MetS and its individual or combined elements were linked with high CAD risk based on contemporary evidence. Thus, the assessment of MetS and its components might help identify people at a higher risk of advancing CAD in the future.
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Affiliation(s)
- Amal F. Alshammary
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.F.A.); (K.K.A.); (N.J.A.)
| | - Khalid Khalaf Alharbi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.F.A.); (K.K.A.); (N.J.A.)
| | - Naif Jameel Alshehri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.F.A.); (K.K.A.); (N.J.A.)
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.F.A.); (K.K.A.); (N.J.A.)
- Correspondence:
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The Synergistic Effect of Plasminogen Activator Inhibitor-1 (PAI-1) Polymorphisms and Metabolic Syndrome on Coronary Artery Disease in the Korean Population. J Pers Med 2020; 10:jpm10040257. [PMID: 33260749 PMCID: PMC7711432 DOI: 10.3390/jpm10040257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 01/24/2023] Open
Abstract
The most common type of cardiovascular disease is coronary artery disease (CAD), in which a plaque builds up inside the coronary arteries that can lead to a complete blockage of blood flow to the heart, resulting in a heart attack. The CAD may be affected by various factors including age, gender, and lipoprotein disposition as well as genetic factors and metabolic syndrome. In this study, we investigated whether three PAI-1 polymorphisms (−844 G > A, −675 4G > 5G, and +43 G > A) and CAD-related clinical parameters are associated with CAD susceptibility. Genotyping of 463 CAD patients and 401 controls was performed using polymerase chain reaction restriction fragment length polymorphism analysis. We report that the 4G5G genotype (crude odds ratio(COR), 1.392; 95% confidence interval (CI), 1.036–1.871; p = 0.028) and dominant model (4G4G vs. 4G5G + 5G5G; COR, 1.401; 95% CI, 1.060–1.850; p = 0.018; adjust odds ratio, 1.371; 95% CI, 1.027–1.831; p = 0.032) of PAI-1 −675 polymorphisms were associated with increased CAD risk. Haplotype and genotype combinations of PAI-1 −675 and +43 polymorphisms show an increased risk of CAD according to alterations of the −675 polymorphism allele or genotype. Moreover, the PAI-1 -675 polymorphisms show a synergistic effect with the metabolic syndrome component of CAD risk. This study suggests that polymorphisms in the PAI-1 genes along with the metabolic syndrome component of CAD can be useful biomarkers for CAD diagnosis and treatment.
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Lee HS, Kim HL, Kim MA, Oh S, Kim M, Park SM, Yoon HJ, Byun YS, Park SM, Shin MS, Hong KS, Shim WJ. Sex Difference in the Association Between Metabolic Syndrome and Obstructive Coronary Artery Disease: Analysis of Data from the KoRean wOmen'S chest pain rEgistry (KoROSE). J Womens Health (Larchmt) 2020; 29:1500-1506. [PMID: 33236950 DOI: 10.1089/jwh.2020.8488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The sex-related impact of metabolic syndrome (MetS) on obstructive coronary artery disease (OCAD) has not been well evaluated. Methods: A total of 1156 patients (62 years and 58% women) with chest pain undergoing invasive coronary angiography (CAG) were recruited from the database of the nation-wide chest pain registry. MetS was defined according to the criteria of the International Diabetes Federation. OCAD was defined as ≥50% stenosis of the left main coronary artery and/or ≥70% stenosis of any other coronary arteries. Results: Women were older than men (65 vs. 59 years, p < 0.001). OCAD (32.0% vs. 30.9%) and MetS (27.8% vs. 27.9%) prevalence rates were similar in both sexes (p > 0.05). The presence of MetS was associated with higher prevalence of OCAD in women (24.5% vs. 47.3%, p < 0.001), but not in men (31.0% vs. 34.3%, p = 0.487). The linear association between the number of components meeting MetS criteria and OCAD prevalence was significant in both sexes (p < 0.001 for each), but it was stronger in women than in men (Chi-square value: 81.9 vs. 14.8, p < 0.001). In a multivariable model, the presence of MetS was independently associated with OCAD in women even after controlling for potential confounders (odds ratio, 1.92; 95% confidence interval, 1.31-2.81; p = 0.001). Conclusions: In patients with chest pain undergoing invasive CAG, the association between the number of components meeting MetS criteria and OCAD prevalence was stronger in women than in men.
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Affiliation(s)
- Hak Seung Lee
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Mina Kim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Sang Min Park
- Division of Cardiology, Hallym University Medical Center, Chuncheon, Korea
| | - Hyun Ju Yoon
- Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea
| | - Young Sup Byun
- Division of Cardiology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Seong Mi Park
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
| | - Mi Seung Shin
- Gachon Medical School Gil Medical Center, Incheon, Korea
| | - Kyung-Soon Hong
- Division of Cardiology, Hallym University Medical Center, Chuncheon, Korea
| | - Wan-Joo Shim
- Division of Cardiology, Korea University Anam Hospital, Seoul, Korea
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Montazerifar F, Bolouri A, Mahmoudi Mozaffar M, Karajibani M. The Prevalence of Metabolic Syndrome in Coronary Artery Disease Patients. Cardiol Res 2016; 7:202-208. [PMID: 28197293 PMCID: PMC5295511 DOI: 10.14740/cr507w] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2016] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a worldwide health problem, which is growing in Iranian adults. MetS is associated with risk of type 2 diabetes and coronary artery disease (CAD). In this study, we aimed to investigate the prevalence of MetS and its individual components in CAD patients. METHODS This cross-sectional study was performed on 200 CAD patients who had undergone elective coronary angiography at the cardiology department. Anthropometric indices including waist circumference (WC) and body mass index were measured. Blood samples were obtained to determine glucose and lipid profile. MetS components were defined according to the modified Adult Treatment Panel III (ATP III) criteria. RESULTS The prevalence of MetS among patients was 49.5% (women: 55.9%; men: 40.2%; P < 0.05). The prevalence increased with age. The low high-density lipoprotein-cholesterol (low HDL-C) (84.8%), high fasting blood glucose (high FBG) (77.8%) and high WC (75.8%) were the most prevalent risk factors in CAD patients with MetS. CONCLUSIONS Recent data indicate that the dyslipidemia, hyperglycemia and abdominal obesity are crucial predictors of MetS in CAD patients. Further prospective studies are recommended for more clarification.
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Affiliation(s)
- Farzaneh Montazerifar
- Pregnancy Health Research Center, Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ahmad Bolouri
- Department of Cardiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Mansour Karajibani
- Health Promotion Research Center, Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Munnur RK, Nerlekar N, Wong DTL. Imaging of coronary atherosclerosis in various susceptible groups. Cardiovasc Diagn Ther 2016; 6:382-95. [PMID: 27500095 DOI: 10.21037/cdt.2016.03.02] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Coronary artery disease (CAD) is the leading cause of death and disability worldwide. Atherosclerosis, which is the primary pathophysiologic mechanism for the development of plaque leading to CAD, is a multifactorial process resulting from a complex interplay between genetic susceptibility and various risk factors such as hypertension (HT), dyslipidaemia, diabetes mellitus (DM) and smoking. In addition, influences from other disease states such as chronic kidney disease (CKD), obesity and the metabolic syndrome as well as gender and ethnic diversity also contribute to the disease process. Insights from pathological observations and advances in cellular and molecular biology have helped us understand the process of plaque formation, progression and rupture leading to events. Several intravascular imaging techniques such as intravascular ultrasound (IVUS), Virtual histology IVUS (VH-IVUS) and optical coherence tomography (OCT) allow in vivo assessment of plaque burden, plaque morphology and response to therapy. In addition, non invasive assessment using coronary artery calcium (CAC) score allows risk stratification and plaque burden assessment whilst computed tomography coronary angiography (CTCA) allows evaluation of luminal stenosis, plaque characterisation and quantification. This review aims to summarise the results of invasive and non-invasive imaging studies of coronary atherosclerosis seen in various high-risk populations including DM, metabolic syndrome, obesity, CKD and, gender differences and ethnicity. Understanding the phenotype of plaques in various susceptible groups may allow potential development of personalised therapies.
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Affiliation(s)
- Ravi Kiran Munnur
- Monash Cardiovascular Research Centre/MonashHEART, Clayton, Victoria, Australia
| | - Nitesh Nerlekar
- Monash Cardiovascular Research Centre/MonashHEART, Clayton, Victoria, Australia
| | - Dennis T L Wong
- Monash Cardiovascular Research Centre/MonashHEART, Clayton, Victoria, Australia
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Razban MM, Eslami M, Bagherzadeh A. The relationship between serum levels of hs-CRP and coronary lesion severity. ACTA ACUST UNITED AC 2016; 89:322-6. [PMID: 27547050 PMCID: PMC4990430 DOI: 10.15386/cjmed-633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 01/26/2016] [Accepted: 02/03/2016] [Indexed: 12/13/2022]
Abstract
Background and aim It is very important to know the risk factors of coronary artery disease and the role of inflammatory markers. One of these markers is hs-CRP that has been indicated to increase in patients with coronary artery atherosclerosis. The main objective of this study was to determine the relationship between serum levels of hs-CRP and coronary lesion severity. Methods In the current study, we evaluated the role of hs-CRP in coronary artery disease and measured the relationship between serum hs-CRP levels and the severity of coronary lesions in 102 patients who referred to Imam Khomeini Hospital, Iran. The number of involved coronary arteries was measured. The severity of coronary lesions was evaluated by Gensini scoring method and the association between severity of coronary artery lesions and serum hs-CRP levels and other risk factors were examined. Results No significant difference was found between the two groups in terms of gender. Severity of lesions had no significant difference according to Gensini score in women compared with men. Mean Gensini score was significant between the two groups (66.79±48.12 in hs-CRP positive group versus 21.09±26.25 in negative ones, p<0.05). In addition, diabetic patients were significantly more in hs-CRP positive group than negative hs-CRP group (P<0.05). In terms of smoking, there was a significant difference between the two groups. Percentage of patients with hypercholesterolemia was significantly higher in hs-CRP negative group. There was a significant difference in severity of lesions between smokers and non-smokers. Conclusion No significant correlation was observed between serum levels of hs-CRP and severity and angiographic extent on coronary arteries in our study. Considering the potential risk of coronary inflammatory process as a new variable, it can help discover new cases of coronary lesions and follow-up and control of the selected cases.
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Affiliation(s)
| | - Masoud Eslami
- Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
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