Endocrinol Metab.  2016 Dec;31(4):559-566. 10.3803/EnM.2016.31.4.559.

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

• Park J
• Lee ES
• Lee DY
• Kim J
• Park SE
• Park CY
• Lee WY
• Oh KW
• Park SW
• Rhee EJ

• KMID: 2373076
• DOI: http://doi.org/10.3803/EnM.2016.31.4.559

Abstract

BACKGROUND
We aimed to assess the risk for coronary artery calcification (CAC) according to groups subdivided by body mass index (BMI) and waist circumference (WC) in apparently healthy Korean adults.
METHODS
Thirty-three thousand four hundred and thirty-two participants (mean age, 42 years) in a health screening program were divided into three groups according to BMI: <23 kg/m² (normal), 23 to 25 kg/m² (overweight), and >25 kg/m² (obese). In addition, the participants were divided into two groups according to WC. Coronary artery calcium score (CACS) was measured with multi-detector computed tomography in all participants. Presence of CAC was defined as CACS >0.
RESULTS
When logistic regression analysis was performed with the presence of CAC as the dependent variable, the risk for CAC increased as BMI increased after adjusting for confounding variables (1.102 [95% confidence interval (CI), 1.000 to 1.216]; 1.284 [95% CI, 1.169 to 1.410]; in the overweight and obese groups vs. the normal weight group). When the participants were divided into six groups according to BMI and WC, the subjects with BMI and WC in the obese range showed the highest risk for CAC (1.321 [95% CI, 1.194 to 1.461]) and those with BMI in the overweight range and WC in the obese range showed the second highest risk for CAC (1.235 [95% CI, 1.194 to 1.461]).
CONCLUSION
Participants with obesity defined by both BMI and WC showed the highest risk for CAC. Those with BMIs in the overweight range but with WC in the obese range showed the second highest risk for CAC, suggesting that WC as a marker of obesity is more predictive of CAC than BMI.

Keyword

Body mass index; Coronary artery calcium score; Waist circumference

MeSH Terms

Adult*
Body Mass Index*
Calcium
Confounding Factors (Epidemiology)
Coronary Vessels*
Humans
Logistic Models
Mass Screening
Obesity*
Overweight
Waist Circumference*
Calcium

Figure

• 

  Fig. 1 Comparison of the (A) mean values of coronary artery calcium score (CACS) and (B) the proportion of subjects with CACS >0 among the groups divided by body mass index (BMI). ANOVA, analysis of variance.

• 

  Fig. 2 Comparison of the (A) mean values of coronary artery calcium score (CACS) and (B) the proportion of subjects with CACS >0 among the groups divided by body mass index (BMI) and waist circumference (WC). Group I: BMI <23 kg/m2 and WC <90 cm in men, <85 cm in women; Group II: BMI <23 kg/m2 and WC ≥90 cm in men, ≥85 cm in women; Group III: BMI 23 to 25 kg/m2 and WC <90 cm in men, <85 cm in women; Group IV: BMI 23 to 25 kg/m2 and WC ≥90 cm in men, ≥85 cm in women; Group V: BMI >25 kg/m2 and WC <90 cm in men, <85 cm in women; Group VI: BMI >25 kg/m2 and WC ≥90 cm in men, ≥85 cm in women. ANOVA, analysis of variance. a,b,cGroups with different letters denote significant differences between the groups in the post hoc analysis.

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