Clinical Significance of Body Fat Distribution in Coronary Artery Calcification Progression in Korean Population

• Published in: Diabetes & metabolism journal 2021, 45(2), 184, pp.219-230
• Main Authors: Lee, Heesun, Park, Hyo Eun, Yoon, Ji Won, Choi, Su-Yeon
• Format: Article
• Language: English
• Subjects: body fat distribution; coronary artery disease; multidetector computed tomography; obesity, abdominal; Original; 내과학
• ISSN: 2233-6079; 2233-6087
• DOI: 10.4093/dmj.2019.0161

Although obesity differs according to ethnicity, it is globally established as a solid risk factor for cardiovascular disease. However, it is not fully understood how obesity parameters affect the progression of coronary artery calcification (CAC) in Korean population. We sought to evaluate the association of obesity-related parameters including visceral adipose tissue (VAT) measurement and CAC progression. This retrospective observational cohort study investigated 1,015 asymptomatic Korean subjects who underwent serial CAC scoring by computed tomography (CT) with at least 1-year interval and adipose tissue measurement using non-contrast CT at baseline for a routine checkup between 2003 and 2015. CAC progression, the main outcome, was defined as a difference of ≥2.5 between the square roots of the baseline and follow-up CAC scores using Agatston units. During follow-up (median 39 months), 37.5% of subjects showed CAC progression of a total population (56.4 years, 80.6% male). Body mass index (BMI) ≥25 kg/m2, increasing waist circumferences (WC), and higher VAT/subcutaneous adipose tissue (SAT) area ratio were independently associated with CAC progression. Particularly, predominance of VAT over SAT at ≥30% showed the strongest prediction for CAC progression (adjusted hazard ratio, 2.20; P