Prevalence and Determinants of Coronary Artery Calcification in Adults With Metabolic Syndrome: A Systematic Review and Meta-Analysis

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-06-02 DOI:10.1002/clc.70156

Aftab Ullah, Asif Jan, Hasan Naeem Kareem, Wahby Mohammed Ahmed Babaresh, Abdur Rahim, Syed Shaukat Ali, Waheed Ali Shah, Salim K. Hajwal, Alaa Hamza Hermis, Mustafa Kareem Jawad, Sajjad Sadeq Salman, Murtadha Abdulridha Ajel, Fatimah Saleh Alsuwayidi, Fadhilah N. Alobaidan, Ameer Hasan Kadhem

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Abstract

Background

Metabolic syndrome (MetS) is a recognized risk factor for coronary artery calcification (CAC), a subclinical marker of atherosclerosis associated with elevated cardiovascular risk. However, the prevalence and determinants of CAC in individuals with MetS have not been comprehensively synthesized. This systematic review and meta-analysis aimed to estimate the pooled prevalence of CAC and identify associated factors among adults with MetS.

Methods

A comprehensive search was conducted in PubMed, LILACS, Web of Science, Embase, Scopus, AJOL, and gray literature through December 2024, following PRISMA 2020 guidelines. Eligible studies included adults (≥ 18 years) with MetS, defined by established criteria, and reported CAC scores via validated CT imaging techniques. Observational studies and RCTs were included. Study quality was assessed using the Joanna Briggs Institute checklist. Pooled estimates were derived using a random-effects model, and heterogeneity was assessed with the I² statistic.

Results

In total, 17 studies comprising 20 745 individuals were included. The pooled prevalence of CAC in adults with MetS was 39.8% (95% CI: 28.4%–52.5%), with wide variation across study design, geography, and imaging modality. Males had a higher CAC prevalence (RR: 2.00), and MetS was linked to increased CAC scores (SMD: 0.10) and odds of calcification (OR: 1.34–1.50). Subgroup analyses showed variability by region and CT modality. High CAC scores were associated with elevated cardiovascular event rates.

Conclusion

CAC affects ~40% of adults with MetS and is associated with higher cardiovascular risk. These findings support the integration of CAC screening in MetS management strategies.

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成人代谢综合征患者冠状动脉钙化的患病率和决定因素：系统回顾和荟萃分析

代谢综合征（MetS）是公认的冠状动脉钙化（CAC）的危险因素，CAC是动脉粥样硬化的亚临床标志，与心血管风险升高相关。然而，在met患者中CAC的患病率和决定因素尚未全面合成。本系统综述和荟萃分析旨在估计成年met患者中CAC的总患病率，并确定相关因素。方法根据PRISMA 2020指南，对截至2024年12月的PubMed、LILACS、Web of Science、Embase、Scopus、AJOL和灰色文献进行综合检索。符合条件的研究包括有MetS的成人（≥18岁），由既定标准定义，并通过经过验证的CT成像技术报告CAC评分。纳入观察性研究和随机对照试验。研究质量采用乔安娜布里格斯研究所的检查表进行评估。使用随机效应模型得出汇总估计，并使用I2统计量评估异质性。结果共纳入17项研究，共20745人。成年met患者中CAC的总患病率为39.8% (95% CI: 28.4%-52.5%)，在研究设计、地理位置和成像方式方面存在很大差异。男性的CAC患病率较高（RR: 2.00）， MetS与CAC评分（SMD: 0.10）和钙化几率（OR: 1.34-1.50）增加有关。亚组分析显示不同区域和CT模态的差异。高CAC评分与心血管事件发生率升高相关。结论约40%的成年MetS患者存在CAC，并伴有较高的心血管风险。这些发现支持将CAC筛查纳入MetS管理策略。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.