ORIGINAL PAPER
Coronary age, based on coronary calcium measurement, is increased in patients with morbid obesity
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Submission date: 2018-09-12
Acceptance date: 2018-09-25
Publication date: 2018-09-05
Pol J Radiol, 2018; 83: 415-420
KEYWORDS
TOPICS
ABSTRACT
Purpose:
Obesity is a well-known of risk factor for atherosclerosis. However, recently an “obesity paradox” has been discussed, which is considered as a protective effect of obesity on the development coronary artery disease (CAD). An aim of the study was to investigate the risk of CAD in morbidly obese patients using coronary artery calcium measurement.
Material and methods:
Fifty-one patients with morbid obesity (BMI ≥ 40 kg/m2) and thirty controls were scanned to determine the amount of coronary artery calcification (CAC), which was expressed as calcium score (CS) and coronary age (CA). The control group consisted of patients scanned for the clinical suspicion of CAD, who did not fulfil the criteria of obesity.
Results:
Mean BMI of obese patients and controls was 47.3 and 26.5, respectively (p < 0.0001). Arterial hypertension, dyslipidaemia, and smoking were more frequent in the control group than in the obesity group (p < 0.02). The prevalence of CAC was higher in the obesity group (53% vs. 23%, p < 0.01). The groups did not differ regarding CS and CA. However, the difference between coronary age and metrical age was higher in obese patients than in controls (+5.6 vs. –4.8 years, respectively, p < 0.005).
Conclusions:
Patients with morbid obesity present an increased risk of CAD that is reflected by the difference between their coronary age and metrical age.
REFERENCES (22)
1.
Grundy SM. Age as a risk factor: you are as old as your arteries. Am J Cardiol 1999; 83: 1455-1457.
2.
Hajer GR, Van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eur Heart J 2008; 29: 2959-2971.
3.
Talman AH, Psaltis PJ, Cameron JD, et al. Epicardial adipose tissue: far more than a fat depot. Cardiovasc Diagn Ther 2014; 4: 416-429.
4.
Niedziela J, Hudzik B, Niedziela N, et al. The obesity paradox in acute coronary syndrome: a meta-analysis. Eur J Epidemiol 2014; 29: 801-812.
5.
Narumi H, Yoshida K, Hashimoto N, et al. Increased subcutaneous fat accumulation has a protective role against subclinical atherosclerosis in asymptomatic subjects undergoing general health screening. Int J Cardiol 2009; 135: 150-155.
6.
Serafin Z, Lasek W, Laskowska K. Phantom-calibrated versus automatic coronary artery mass quantification with multidetector-row computed tomography: in vitro and in vivo study. Acta Radiol 2008; 49: 1007-1015.
7.
Serafin Z, Rusak G, Strześniewski P, et al. Comparison of Calcium Scoring With 4-Multidetector Computed Tomography (4-MDCT) and 64-MDCT. J Comput Assist Tomogr 2012; 36: 88-93.
8.
Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827-832.
9.
Schmermund A, Erbel R, Silber S, MUNICH Registry Study Group. Multislice Normal Incidence of Coronary Health. Age and gender distribution of coronary artery calcium measured by four-slice computed tomography in 2,030 persons with no symptoms of coronary artery disease. Am J Cardiol 2002; 90: 168-173.
10.
McClelland RL, Chung H, Detrano R, et al. Distribution of coronary artery calcium by race, gender, and age: Results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 2006; 113:.
13.
Serafin Z, Karolkiewicz M, Gruszka M, et al. High incidence of nephropathy in neurosurgical patients after intra-arterial administration of low-osmolar and iso-osmolar contrast media. Acta Radiol 2011; 52: 422-429.
14.
McGill HC, McMahan CA, Herderick EE, et al. Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation 2002; 105: 2712-2718.
15.
Burke GL, Bertoni AG, Shea S, et al. The impact of obesity on cardiovascular disease risk factors and subclinical vascular disease: The multi-ethnic study of atherosclerosis. Arch Intern Med 2008; 168: 928-935.
16.
Gadelha PS, Campos JM, Moraes F, et al. Altered coronary artery calcium scores before bariatric surgery. Springerplus 2014; 3: 199.
17.
Lee CD, Jacobs DR, Schreiner PJ, et al. Abdominal obesity and coronary artery calcification in young adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr 2007; 86: 48-54.
18.
Arad Y, Newstein D, Cadet F, et al. Association of multiple risk factors and insulin resistance with increased prevalence of asymptomatic coronary artery disease by an electron-beam computed tomographic study. Arter Thromb Vasc Biol 2001; 21: 2051-2058.
19.
Cassidy AE, Bielak LF, Zhou Y, et al. Progression of subclinical coronary atherosclerosis: Does obesity make a difference? Circulation 2005; 111: 1877-1882.
20.
Mahoney L, Burns T, Stanford W, et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996; 27: 277-284.
21.
Shaw LJ, Raggi P, Berman DS, Callister TQ. Coronary artery calcium as a measure of biologic age. Atherosclerosis 2006; 188: 112-119.
22.
Nasir K, Vasamreddy C, Blumenthal RS, Rumberger J. Comprehensive coronary risk determination in primary prevention: an imaging and clinical based definition combining computed tomographic coronary artery calcium score and national cholesterol education program risk score. Int J Cardiol 2006; 110: 129-136.