The Relationship of Body Composition and Coronary Artery Calcification in Apparently Healthy Korean Adults

Abstract

BackgroundWe investigated the association of coronary artery calcium score (CACS) with body composition and insulin resistance in apparently healthy Korean adults.MethodsNine hundred forty-five participants (mean age, 48.9 years; 628 men) in a medical check-up program were selected for analysis. Body composition was assessed by bioelectrical impedance analysis (BIA). Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR). The CACS was assessed by multidetector computed tomography.ResultsOne hundred forty-six subjects (15.4%) showed coronary artery calcification and 148 subjects (15.7%) had metabolic syndrome. CACS showed a significant positive correlation with age, fasting glucose level, waist circumference (WC), blood pressure, hemoglobin A1c, HOMA-IR, and waist-hip ratio (WHR) assessed by BIA. CACS had a negative correlation with high density lipoprotein cholesterol (HDL-C). Subjects with high CACS showed significantly higher mean WHRs and lower mean values for lean body mass compared with subjects without coronary artery calcification. In logistic regression analyses with coronary artery calcification as the dependent variable, the highest quartile of WHR showed a 3.125-fold increased odds ratio for coronary artery calcification compared with the lowest quartile after adjustment for confounding variables. When receiver operating characteristics analyses were performed with coronary artery calcification as the result variable, WHR showed the largest area under the curve (AUC) value among other variables except for age and WC in women (AUC=0.696 for WHR, 0.790 for age, and 0.719 for WC in women).ConclusionIn our study population of apparently healthy Korean adults, WHR was the most significant predictor for coronary artery calcification among other confounding factors, suggesting that it may have implication as a marker for early atherosclerosis.

Waist Circumference as a Marker of Obesity Is More Predictive of Coronary Artery Calcification than Body Mass Index in Apparently Healthy Korean Adults: The Kangbuk Samsung Health Study

“…In a study performed in 321 Japanese participants, Ohashi et al [24] reported that visceral adiposity was significantly associated with the presence and extent of CAC. In a study of 924 healthy Koreans, CAC showed a significant positive correlation with WC, WHR, and WHR as the most significant predictors for CAC [7]. Our study showed that the group that met the criteria for obesity by both BMI and WC had the highest CAC risk, followed by the group that met the criteria for overweight by BMI and obesity by WC.…”

“…Thus, indices that reflect central obesity such as WC, waist-hip ratio (WHR), and waist-height ratio (WHtR) have gained popularity for the measurement of relative visceral fat distribution [56]. Visceral obesity is a strong risk factor for metabolic disorders and is associated with increased risk for CVD [47]. …”

Metabolic Health Is a More Important Determinant for Diabetes Development than Simple Obesity: A 4-Year Retrospective Longitudinal Study

“…Furthermore, not the actual amount of adipose tissue, but where they are deposited affects more of their metabolic function; for example, visceral fat is the starting point for the insulin resistance and atherosclerosis as it is more prone to lipolysis and releases free fatty acid to the circulation, whereas subcutaneous fat is known for the protective effect against insulin resistance and obesity [2], [3].…”

Increased Risk for Intracranial Arterial Stenosis in Subjects With Coronary Artery Calcification

“…16,17 Increased coronary artery calcium score (CACS) is known to correlate with the risk of cardiovascular disease and various metabolic diseases. 18,19 A recent study reported the association of increased CACS with development of ischemic stroke in a large CAC-based cohort. 20 There is no single imaging method for the determination of whole-body atherosclerotic status.…”