S1452° Metabolic Syndrome Is Not Associated with Mesenteric Ischemia

Abstract

Introduction: Metabolic syndrome (MetS) is an increasingly prevalent pathological condition with multiple components such as insulin resistance, hyperlipidemia and increased abdominal adiposity. MetS has previously been associated with increased risk of coronary artery disease (CAD), myocardial infarction (MI), stroke and diabetes. It has been well established with many atherosclerotic processes, however its impact on the development of mesenteric ischemia has not been studied. The purpose of this study is to evaluate if an association between mesenteric ischemia and MetS exists. Methods: We queried a commercial database (Explorys Inc, Cleveland, OH) with electronic medical record data from 26 major U.S. healthcare systems. Adult patients ( >/=18 years old) with and without MetS between 1999 and 2021 were identified based on systematized nomenclature of medicine-Clinical Terms (SNOMED-CT). Differences in baseline characteristics and demographics were analyzed using chi-squared tests. Odds ratio analyses were performed between MetS and non-MetS patients for the presence of acute mesenteric ischemia (AMI), chronic mesenteric ischemia (CMI), coronary artery disease (CAD), peripheral vascular disease (PVD), myocardial infarction (MI), cerebrovascular accident (CVA). We defined P-values less than 0.05 to be statistically significant. Results: A total of 102,360 individuals were found to with and without MetS in the database. Of those patients, 1360 (1.3%) had MetS. MetS patients were more likely to be under the age of 65 (35.3% vs 20.9%, P< 0.0001), more likely to be female (66.9% vs 63.6%, P=0.0399), identified more commonly as White (84.6% vs 80.8%, P< 0.0001) and were more likely to be smokers (86.8% vs 71.5%, P< 0.0001). MetS patients were more likely to have CAD (OR: 1.65, P< 0.0001), PVD (OR: 1.99, P< 0.0001), MI (OR: 1.42, P< 0.0001) and CVA (OR:1.44, P< 0.0001) (Table). There was no difference in acute or chronic mesenteric ischemia. Conclusion: This study found no association between MetS and mesenteric ischemia but did have similar findings relating to other established cardiovascular conditions in other studies. This suggests that another atherosclerotic mechanism exists which contributes to mesenteric ischemia, particularly chronic mesenteric ischemia. Table 1. - Comparison of Outcomes Between Metabolic Syndrome (MetS) and Non-Metabolic Syndrome (non-MetS) Patients Event MetS (N=1,360) MetS (%) No MetS (N=101,000) Non-MetS (%) P-Value Odds Ratio CI (95%) Acute mesenteric ischemia 540 39.7% 38,110 37.7% 0.1361 1.0867 0.9741, 1.2123 chronic mesenteric ischemia 300 22.1% 22,540 22.3% 0.8204 0.9852 0.8659, 1.1208 Coronary artery disease 710 52.2% 40,170 39.8% < 0.0001 1.6541 1.4860, 1.8412 Peripheral arterial/vascular disease 960 70.6% 55,140 54.6% < 0.0001 1.9961 1.7752, 2.2445 Myocardial infarction 390 28.7% 22,220 22.0% < 0.0001 1.4255 1.2662, 1.6048 Stroke 490 36.0% 28,380 28.1% < 0.0001 1.4412 1.2891, 1.6113 Characteristics Female 910 66.9% 64,270 63.6% 0.0399 Male 450 33.1% 36,720 36.4% 0.1481 >65 880 64.7% 70,450 69.8% 0.0011 18-65 480 35.3% 21,150 20.9% < 0.0001 White 1,150 84.6% 81,580 80.8% 0.0011 AA 150 11.0% 10,580 10.5% 0.8428 Asian 20 1.5% 1,340 1.3% 0.9376 Multirace 20 1.5% 910 0.9% 0.7803 Unknown 210 15.4% 13,210 13.1% 0.3276 Other 50 3.7% 2,450 2.4% 0.5543 Refused 30 2.2% 1,590 1.6% 0.796 Hispanic/Latino N/A N/A 610 0.6% N/A asian/pacific islander N/A N/A 180 0.2% N/A native america/alaskan native N/A N/A 120 0.1% N/A Cardiomyopathy 220 16.2% 10,430 10.3% 0.0046 CHF 470 34.6% 27,770 27.5% 0.0006 COPD 530 39.0% 31,960 31.6% 0.0003 HTN 1,250 91.9% 76,780 76.0% < 0.0001 HLD 1,230 90.4% 65,310 64.7% < 0.0001 DM 910 66.9% 34,430 34.1% < 0.0001 CKD 600 44.1% 29,730 29.4% < 0.0001 ESRD 160 11.8% 7140 7.1% 0.023 Presence of cirrhosis 140 10.3% 5,100 5.0% 0.0051 Alcohol abuse 80 5.9% 5,860 5.8% 0.9697 tobacco abuse/smoking 1,180 86.8% 72,240 71.5% < 0.0001 Obesity 920 67.6% 23,330 23.1% < 0.0001