Abstract
OBJECTIVE: To test the hypothesis that three measures of body morphology would be differentially correlated with and predictive of coronary artery calcification.
DESIGN: Cross-sectional analytic study of body mass index (BMI), central adiposity (‘visceral fat’) and total body percent fat.
SUBJECTS: In a total of 3028 healthy, free living men and women (mean age and BMI: 56.7 and 27.0, respectively).
MEASUREMENTS: Coronary calcification and visceral fat (VF) content was measured using electron beam computed tomography while percent body fat (BF) was determined using bioimpedence.
RESULTS: In men, the median coronary calcium score increased from 6.7 for a BMI ≤24 to 30.9 for a BMI ≥30; from 3.6 to 46.4 between the first and fourth quartile of VF; and from 1 to 97.6 for the same in BF. There were no significant increases in calcium scores in women for any of these indices. There were also no significant age-adjusted correlations between BMI, BF and VF with the extent of coronary calcium in either gender. On multivariable logistic regression analysis, men with a BMI in the third and fourth quartiles had 1.64 and 2.01 times increase in risk, respectively, for the presence of any coronary calcium compared to those in the first quartile (P≤0.01 for both) while men in the highest quartile for VF had a 63% increase in this same risk (P=0.04). For women, a BMI in the fourth quartile was associated with a 68% increase in risk for the presence of any coronary calcium (P=0.01).
CONCLUSION: BMI is a significant predictor of coronary calcium. In men, central adiposity is also an independent predictor. These findings lend further support to weight control for coronary disease prevention.
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References
Seidell JC, Oosterlee A, Deurenberg P, Hautvast JG, Ruijs JH . Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex, and age. Eur J Clin Nutr 1988; 42: 805–815.
Harris MM, Stevens J, Thomas N, Schreiner P, Folsom AR . Associations of fat distribution and obesity with hypertension in a bi-ethnic population: the ARIC study. Atherosclerosis Risk in Communities Study. Obes Res 2000; 8: 516–524.
Pausova Z, Jomphe M, Houde L, Vezina H, Orlov SN, Gossard F, Gaudet D, Tremblay J, Kotchen T, Cowley AW, Bouchard G, Hamet P . A genealogical study of essential hypertension with and without obesity in French Canadians. Obes Res 2002; 10: 463–470.
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS . Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289: 76–79.
Seki A, Takigawa T, Ito T, Fukuoka E, Takahashi K, Kira S . Obesity and the risk of diabetes mellitus in middle-aged Japanese men. Acta Med Okayama 2002; 56: 255–260.
Garrison RJ, Wilson PW, Castelli WP, Feinleib M, Kannel WB, McNamara PM . Obesity and lipoprotein cholesterol in the Framingham offspring study. Metabolism 1980; 29: 1053–1060.
Ishikawa-Takata K, Ohta T, Moritaki K, Gotou T, Inoue S . Obesity, weight change and risks for hypertension, diabetes and hypercholesterolemia in Japanese men. Eur J Clin Nutr 2002; 56: 601–607.
Kannel WB, Cupples LA, Ramaswami R, Stokes III J, Kreger BE, Higgins M . Regional obesity and risk of cardiovascular disease; the Framingham Study. J Clin Epidemiol 1991; 44: 183–190.
Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT . The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. Jama 2002; 288: 2709–2716.
Achenbach S, Ropers D, Mohlenkamp S, Schmermund A, Muschiol G, Groth J, Kusus M, Regenfb M, Daniel WG, Erbel R, Moshage W . Variability of repeated coronary artery calcium measurements by electron beam tomography. Am J Cardiol 2001; 87: 210–213, A218.
Mautner GC, Mautner SL, Froehlich J, Feuerstein IM, Proschan MA, Roberts WC, Doppman JL . Coronary artery calcification: assessment with electron beam CT and histomorphometric correlation. Radiology 1994; 192: 619–623.
Georgiou D, Budoff MJ, Kaufer E, Kennedy JM, Lu B, Brundage BH . Screening patients with chest pain in the emergency department using electron beam tomography: a follow-up study. J Am Coll Cardiol 2001; 38: 105–110.
Vliegenthart R, Oudkerk M, Song B, van der Kuip DA, Hofman A, Witteman JC . Coronary calcification detected by electron-beam computed tomography and myocardial infarction. The Rotterdam Coronary Calcification Study. Eur Heart J 2002; 23: 1596–1603.
Wong ND, Hsu JC, Detrano RC, Diamond G, Eisenberg H, Gardin JM . Coronary artery calcium evaluation by electron beam computed tomography and its relation to new cardiovascular events. Am J Cardiol 2000; 86: 495–498.
Park R, Detrano R, Xiang M, Fu P, Ibrahim Y, LaBree L, Azen S . Combined use of computed tomography coronary calcium scores and C-reactive protein levels in predicting cardiovascular events in nondiabetic individuals. Circulation 2002; 106: 2073–2077.
Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte Jr M, Detrano R . Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827–832.
Arad Y, Spadaro LA, Goodman K, Newstein D, Guerci AD . Prediction of coronary events with electron beam computed tomography. J Am Coll Cardiol 2000; 36: 1253–1260.
Hoff JA, Chomka EV, Krainik AJ, Daviglus M, Rich S, Kondos GT . Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults. Am J Cardiol 2001; 87: 1335–1339.
Nieves DJ, Cnop M, Retzlaff B, Walden CE, Brunzell JD, Knopp RH, Kahn SE . The atherogenic lipoprotein profile associated with obesity and insulin resistance is largely attributable to intra-abdominal fat. Diabetes 2003; 52: 172–179.
Campos H, Moye LA, Glasser SP, Stampfer MJ, Sacks FM . Low-density lipoprotein size, pravastatin treatment, and coronary events. JAMA 2001; 286: 1468–1474.
Luc G, Bard JM, Ferrieres J, Evans A, Amouyel P, Arveiler D, Fruchart JC, Ducimetiere P . Value of HDL cholesterol, apolipoprotein A-I, lipoprotein A-I, and lipoprotein A-I/A-II in prediction of coronary heart disease: the PRIME Study Prospective Epidemiological Study of Myocardial Infarction. Arterioscler Thromb Vasc Biol 2002; 22: 1155–1161.
Nguyen-Duy TB, Nichaman MZ, Church TS, Blair SN, Ross R . Visceral fat and liver fat are independent predictors of metabolic risk factors in men. Am J Physiol Endocrinol Metab 2003; 284: E1065–E1071.
Festa A, D'Agostino Jr R, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM . The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Relat Metab Disord 2001; 25: 1407–1415.
Cermak J, Key NS, Bach RR, Balla J, Jacob HS, Vercellotti GM . C-reactive protein induces human peripheral blood monocytes to synthesize tissue factor. Blood 1993; 82: 513–520.
de Beer FC, Soutar AK, Baltz ML, Trayner IM, Feinstein A, Pepys MB . Low density lipoprotein and very low density lipoprotein are selectively bound by aggregated C-reactive protein. J Exp Med 1982; 156: 230–242.
Wang TJ, Larson MG, Levy D, Benjamin EJ, Kupka MJ, Manning WJ, Clouse ME, D'Agostino DB, Wilson PW, O'Donnell CJ . C-reactive protein is associated with subclinical epicardial coronary calcification in men and women: the Framingham Heart Study. Circulation 2002; 106: 1189–1191.
Kelley DE, Williams KV, Price JC, McKolanis TM, Goodpaster BH, Thaete FL . Plasma fatty acids, adiposity, and variance of skeletal muscle insulin resistance in type 2 diabetes mellitus. J Clin Endocrinol Metab 2001; 86: 5412–5419.
Zhu S, Wang Z, Shen W, Heymsfield SB, Heshka S . Percentage body fat ranges associated with metabolic syndrome risk: results based on the third National Health and Nutrition Examination Survey (1988–1994). Am J Clin Nutr 2003; 78: 228–235.
Kondos GT, Hoff JA, Sevrukov A, Daviglus ML, Garside DB, Devries SS, Chomka EV, Liu K . Electron-beam tomography coronary artery calcium and cardiac events. A 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 2003.
Anonymous. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.
Flegal KM, Carroll MD, Ogden CL, Johnson CL . Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002; 288: 1723–1727.
Acknowledgements
We thank Robert D Langer, MD, MPH, for his assistance in the preparation of this manuscript. Grant support: MO1-RR00827 from the NIH NCRR for the UCSD CRC and by American Heart Association (AHA) project number 0325002Y.
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Allison, M., Michael Wright, C. Body morphology differentially predicts coronary calcium. Int J Obes 28, 396–401 (2004). https://doi.org/10.1038/sj.ijo.0802571
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DOI: https://doi.org/10.1038/sj.ijo.0802571
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