Abstract 5156: Obstructive Sleep Apnea, Obesity, and Coronary Artery Calcification in Middle-Aged Men
Obesity is associated with coronary artery calcification (CAC), and obstructive sleep apnea (OSA) is highly prevalent in obese subjects. Although OSA is known to be an independent risk factor for the development of coronary heart disease, it is unclear if OSA is associated with CAC independently of obesity. We conducted a population-based study of 258 randomly selected healthy men 40 to 49 years of age. All subjects were grouped by quartile of apnea-hypopnea index (AHI) severity and divided into three groups according to degree of obesity: normal weight, overweight, and obese. CAC was measured by electron beam computed tomography, and OSA was confirmed by polysomnography. In multivariable logistic regression analyses, the presence of CAC was significantly greater in the fourth versus the first quartile of AHI severity [odds ratio (OR) 2.2, 95% CI 1.0 – 4.8]. In multivariable linear regression analyses, AHI was significantly associated with log (CAC + 1) after adjustment for the covariates (P= .004). After adding body mass index (BMI) as a risk factor, AHI was no longer associated with the presence and quantity of CAC in multivariable logistic and linear regression analyses. However, obesity categories remained significantly associated with the presence and quantity of CAC in multivariable logistic (OR 4.1, 95% CI 1.8 –9.1 for overweight and OR 15.1, 95% CI 4.6 – 49.2 for obese) and linear regression analyses (P < .001), independent of OSA. Although both OSA and obesity were associated with the presence and extent of CAC, only obesity remained a significant independent contributor after adjusting for traditional risk factors, irrespective of OSA.