Additive effect of low skeletal muscle mass and abdominal obesity on coronary artery calcification

in European Journal of Endocrinology
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  • 1 Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee School of Medicine, Seoul, Republic of Korea pages: 867-878
  • 2 Department of Health Promotion Center, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  • 3 Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
  • 4 Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
  • 5 Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea

Correspondence should be addressed to J H Kim; Email: jaehyeon@skku.edu

Objective

We aimed to investigate the interaction of reduced skeletal muscle mass and abdominal obesity on coronary artery calcification (CAC).

Design and methods

A total of 19 728 adults free of cardiovascular disease (CVD) who contemporaneously underwent cardiac tomography and bioelectrical impedance analysis were enrolled in a cross-sectional and longitudinal cohort. Skeletal muscle mass index (SMI) was calculated using the following formula: SMI (%) = total appendicular muscle mass (kg)/body weight (kg) × 100 according to sex. CAC presence or incidence was defined as CAC score > 0, and CAC progression was defined as √CAC score (follow-up) – √CAC score (baseline)>2.5. Pre-sarcopenia was defined as SMI ≤ −1.0 s.d. of the sex-specific mean of a young reference group. Abdominal obesity was defined as waist circumference ≥ 90 cm for men and ≥85 cm for women. All individuals were further classified into four groups: normal, abdominal obesity alone, pre-sarcopenia alone, and pre-sarcopenic obesity.

Results

Individuals with pre-sarcopenic obesity showed the highest adjusted odds ratio (AOR) for CAC presence (AOR 2.16, 95% CI : 1.98–2.36, P < 0.001) as well as total CAC incidence and progression (adjusted hazard ratio: 1.54, 95% CI: 1.37–1.75, P < 0.001), compared with normal individuals. Pre-sarcopenic obesity significantly increased CAC incidence and progression compared to either pre-sarcopenia or abdominal obesity alone.

Conclusion

Pre-sarcopenia and abdominal obesity together were significantly associated with a higher CAC presence and increased risk of CAC incidence and progression, independent of traditional CVD risk factors.

Supplementary Materials

    • Supplementary Table 1. Calculations of visceral adiposity index and a body shape index
    • Supplementary Table 2. Descriptive data for individuals in the young reference group (20-39 years) according to sex
    • Supplementary Table 3. Odds ratios and hazard ratios of CAC in individuals with abdominal obesity alone or pre-sarcopenia alone as a reference
    • Supplementary Table 4. Subgroup analyses of CAC presence
    • Supplementary Table 5. Associations between CAC presence and other definitions of obesity instead of using waist circumference
    • Supplementary Table 6. Subgroup analyses of CAC incidence and progression
    • Supplementary Table 7. Associations between CAC incidence/progression and other definitions of obesity instead of using waist circumference

 

     European Society of Endocrinology

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