Association between metabolic syndrome severity score and coronary artery disease complexity assessed by the SYNTAX score in patients with chronic coronary syndrome
- 1Department of Family Medicine, Trabzon University
- 2Department of Cardiology, Trabzon University
- 3Department of Biochemistry, Trabzon University
Abstract
Background: Metabolic syndrome represents a cluster of interrelated cardiometabolic abnormalities associated with coronary artery disease. However, conventional definitions evaluate metabolic syndrome categorically and may not adequately reflect its cumulative severity. The primary objective of this study was to assess whether the metabolic syndrome severity Z-score (MetS-Sz) was independently associated with coronary artery disease complexity, as quantified by the SYNTAX score, in patients with chronic coronary syndrome.
Methods: This single-center retrospective cross-sectional study included 156 patients with chronic coronary syndrome who underwent coronary angiography. MetS-Sz was calculated using age-, sex-, race-, and body mass index-based metabolic variables, whereas coronary lesion complexity was assessed using the SYNTAX score. Participants were categorized into lower (MetS-Sz < 0) and higher (MetS-Sz ≥ 0) MetS-Sz groups, corresponding to values below and at or above the reference population mean. Clinical, anthropometric, and biochemical characteristics were compared between groups. Correlation analysis and multiple linear regression were performed to evaluate the association between MetS-Sz and the SYNTAX score.
Results: Of the 156 participants, 123 (78.8%) were men and 33 (21.2%) were women. Patients in the higher MetS-Sz group had significantly higher body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, glucose, diastolic blood pressure, and SYNTAX scores and lower high-density lipoprotein cholesterol levels than those in the lower MetS-Sz group (all p < 0.05). MetS-Sz was positively correlated with the SYNTAX score ( r s = 0.675, p < 0.001). The multiple linear regression model was statistically significant ( F = 22.84, p < 0.001) and explained 51.9% of the variance in the SYNTAX score (R ² = 0.519). MetS-Sz, low-density lipoprotein cholesterol, body mass index, triglyceride level, and smoking status were independently associated with the SYNTAX score, whereas diabetes and diastolic blood pressure were not significantly associated with it.
Conclusions: Higher MetS-Sz was independently associated with greater coronary artery disease complexity in patients with chronic coronary syndrome. These findings suggest that assessment of cumulative metabolic burden using MetS-Sz may complement conventional cardiovascular risk evaluation. Prospective, multicenter studies are required to confirm its potential role in coronary risk stratification.
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BibTeX
@article{vatansever2026association,
title = {{Association between metabolic syndrome severity score and coronary artery disease complexity assessed by the SYNTAX score in patients with chronic coronary syndrome}},
author = {Mehmet Vatansever and Ahmet Özderya and Fatma Yılmaz Tulumcu and Yılmaz Sezgin and Serap Özer Yaman},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1907964},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1907964/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between metabolic syndrome severity score and coronary artery disease complexity assessed by the SYNTAX score in patients with chronic coronary syndrome
AU - Mehmet Vatansever
AU - Ahmet Özderya
AU - Fatma Yılmaz Tulumcu
AU - Yılmaz Sezgin
AU - Serap Özer Yaman
PY - 2026
DA - 2026/10/28
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1907964
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1907964/full
AB - Background: Metabolic syndrome represents a cluster of interrelated cardiometabolic abnormalities associated with coronary artery disease. However, conventional definitions evaluate metabolic syndrome categorically and may not adequately reflect its cumulative severity. The primary objective of this study was to assess whether the metabolic syndrome severity Z-score (MetS-Sz) was independently associated with coronary artery disease complexity, as quantified by the SYNTAX score, in patients with chronic coronary syndrome. Methods: This single-center retrospective cross-sectional study included 156 patients with chronic coronary syndrome who underwent coronary angiography. MetS-Sz was calculated using age-, sex-, race-, and body mass index-based metabolic variables, whereas coronary lesion complexity was assessed using the SYNTAX score. Participants were categorized into lower (MetS-Sz < 0) and higher (MetS-Sz ≥ 0) MetS-Sz groups, corresponding to values below and at or above the reference population mean. Clinical, anthropometric, and biochemical characteristics were compared between groups. Correlation analysis and multiple linear regression were performed to evaluate the association between MetS-Sz and the SYNTAX score. Results: Of the 156 participants, 123 (78.8%) were men and 33 (21.2%) were women. Patients in the higher MetS-Sz group had significantly higher body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, glucose, diastolic blood pressure, and SYNTAX scores and lower high-density lipoprotein cholesterol levels than those in the lower MetS-Sz group (all p < 0.05). MetS-Sz was positively correlated with the SYNTAX score ( r s = 0.675, p < 0.001). The multiple linear regression model was statistically significant ( F = 22.84, p < 0.001) and explained 51.9% of the variance in the SYNTAX score (R ² = 0.519). MetS-Sz, low-density lipoprotein cholesterol, body mass index, triglyceride level, and smoking status were independently associated with the SYNTAX score, whereas diabetes and diastolic blood pressure were not significantly associated with it. Conclusions: Higher MetS-Sz was independently associated with greater coronary artery disease complexity in patients with chronic coronary syndrome. These findings suggest that assessment of cumulative metabolic burden using MetS-Sz may complement conventional cardiovascular risk evaluation. Prospective, multicenter studies are required to confirm its potential role in coronary risk stratification.
SN - 2297-055X
ER -