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27 This reinforces the atherogenicity concept of diabetes, which may exert deleterious proatherogenic effects by glycation, inflammation, and oxidative stress. Furthermore, diabetes was accompanied by vascular constriction and small lumen volumes, despite the presence of more extensive atheroma burden. In the same study, metabolic syndrome was associated with larger vessel dimensions and no greater disease burden (compared to patients with neither condition), suggesting different effects on remodeling. This highlights clear differences between metabolic syndrome and diabetes with regard to how the vessel wall responds to plaque accumulation. Another study in women showed that women with diabetes had more severe angiographic disease than those without diabetes, while no association was found between angiographic scores and metabolic syndrome. In multivariate analysis, high triglycerides and low HDL were predictors http://www.selleckchem.com/products/Maraviroc.html of angiographically proven CAD.8 In our study, we also observed a direct relationship between diabetes and CAD and no relationship with metabolic syndrome. We also confirmed the importance of triglycerides http://www.selleckchem.com/products/pirfenidone.html as a predictor of CAD. The absence of association between total cholesterol and LDL cholesterol with CAD may be explained by the high rate of lipid-lowering therapy use in our population, which was 60% (56.6% with statins, 1.7% with fibrates and 1.7% with both). This may explain the relatively low levels of total cholesterol and LDL cholesterol; almost 75% of the study population had LDL cholesterol http://www.selleck.cn/products/Paclitaxel(Taxol).html Multivariate analysis also adjusted the results for age. The comorbidities usually associated with low and high BMI are also suggested as an explanation for the better outcome observed in overweight patients after acute coronary syndromes. However, in our study, obese patients showed a trend to lower CAD prevalence, but not overweight patients. This may be explained by the fact that, as previously shown, BMI is directly related to coronary vessel diameter.31 This leads us to conclude that to cause 50% stenosis, the atherosclerotic plaque needs to be significantly thicker in high BMI patients than in low BMI patients.