Obesity and coronary artery calcification: Can it explain the obesity-paradox?

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• 作者：Ahmed Aljizeeri ; Thais Coutinho ; Ally Pen…
• 关键词：Computed tomography ; Coronary artery calcification ; Obesity ; Body mass index ; Body surface area ; Body fat percentage
• 刊名：The International Journal of Cardiovascular Imaging (formerly Cardiac Imaging)
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：31
• 期：5
• 页码：1063-1070
• 全文大小：360 KB
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• 作者单位：Ahmed Aljizeeri (1) (2) (3)
  Thais Coutinho (1) (2)
  Ally Pen (2)
  Li Chen (2) (4)
  Yeung Yam (1) (2)
  Robert Dent (1)
  Ruth McPherson (1) (2)
  Benjamin J. W. Chow (1) (2) (5)
  
  1. Department of Medicine, University of Ottawa, Ottawa, Canada
  2. Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada
  3. King Abdulaziz Cardiac Center, Riyadh, Saudi Arabia
  4. Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada
  5. Department of Radiology, University of Ottawa, Ottawa, Canada
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  
• 出版者：Springer Netherlands
• ISSN：1573-0743

文摘

The inverse relationship between obesity and adverse cardiovascular outcomes has been coined the ‘obesity-paradox- We sought to determine the relationship between measures of obesity [body mass index (BMI), body surface area (BSA) and body fat percentage (BF%)] and coronary artery calcification (CAC). We retrospectively analyzed patients who underwent CAC using the Agatston score. Baseline demographics were collected and BMI, BSA and BF% were calculated. A two-stage regression modeling approach was used to evaluate the association between BMI, BSA, BF% and Agatston score. Of the 6661 patients [mean age?=?57.1?±?10.8?years, men?=?54.3?%, median Agatston score?=?14 (0, 163)], 0.1?% were underweight, 21.3?% had normal BMI, 39.1?% were overweight and 39.4?% were obese. The mean BMI, BSA and BF% were 29.6?±?6.1?kg/m2, 1.97?±?0.25?m2 and 37?±?10?%, respectively. There was an independent association between the presence of CAC and BMI (5?kg/m2 increments) (OR 1.05, CI 1.00-.11, P?=?0.038) and BF% (OR 2.38, CI 1.05-.41, P?=?0.038). Neither BMI categories nor large BSA independently predicted the presence of CAC. BF% predicted the extent of CAC in men but not?in women, and higher BF% was associated with higher category of CAC severity in men only. BMI and BF% were independent predictors of the presence of CAC. BF% was associated with the extent of CAC and higher BF% was associated with higher category of CAC severity in men only. These results suggest that further study is needed to better understand the obesity-paradox.