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Obesity linked to coronary artery calcification in patients without diabetes
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Coronary artery calcification was linked to obesity, but not impaired fasting glucose, according to results from a community-based study of the offspring and third-generation cohorts of the initial Framingham Heart Study.
“In the US population, approximately one in three nondiabetic adults has impaired fasting glucose (IFG) and one in three has obesity. IFG is known to be related to all components of the metabolic syndrome, including strong associations with obesity,” researchers wrote.
Using multidetector computed tomography in 3,054 patients (mean age of 50 years; 49% women; 29% impaired fasting glucose [IFG] and 25% obese), researchers compared the coronary artery calcification (CAC) of patients with normal fasting glucose and IFG. Comparisons were also completed on the CAC of patients with and without obesity. Researchers aimed to determine if CAC differences were independent of important confounders.
Martin K. Rutter, MD, from the cardiovascular research group within the School of Biomedicine at the University of Manchester in the United Kingdom, and colleagues said the relationships of IFG and obesity to CAC in the general population has been ambiguous until now.
“Although this is cross-sectional observational data, our work may have public health implications because it has suggested the possible importance of targeting obesity over IFG for preventing subclinical atherosclerosis in the general population,” the researchers wrote.
Data confirmed that high CAC was significantly related to IFG in an age- and sex-adjusted model (OR=1.4; 95% CI, 1.1–1.7), and after additional adjustments for obesity, high CAC still showed a relation to IFG (OR=1.3; 95% CI, 1–1.6).
However, IFG was not associated with high CAC in multivariable-adjusted models before (OR=1.2; 95% CI, 0.9–1.4) or after adjustment for obesity, they wrote.
Moreover, obesity was linked to higher CAC in age- and sex-adjusted models (OR=1.6; 95% CI, 1.3–2.0) and in multivariable models, including IFG (OR=1.4; 95% CI, 1.1–1.7), according to data.
Finally, researchers used a spline regression model to explore the nonlinear relationships linking CAC with BMI, fasting glucose and waist circumference.
“This suggested that there is a J-shaped multivariable-adjusted relationship between BMI and CAC with significant nonlinearity in the nonobese BMI range.”
Despite consistent evidence for improved risk prediction by CAC, Rutter and colleagues said that CHD screening using CAC currently is not recommended to improve clinical outcomes.
Disclosure: The researchers report no relevant financial disclosures.
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