Abstract 13068: Measures of Adiposity and Presence of Subclinical Atherosclerosis in Retired National Football League Players
Background: It is not known which measure of adiposity (body mass index [BMI] or waist circumference [WC]) is best associated with subclinical atherosclerosis in athletes who often have increased BMI, and whether this relationship is attenuated after adjusting for metabolic risk factors that frequently coexist with obesity.
Methods: Coronary artery calcium (CAC) scoring (a surrogate for subclinical atherosclerosis) was performed in 931 retired National Football League (NFL) players. BMI (weight in Kg/height in metres2) and WC (in inches) were measured. We performed logistic regression analyses adjusting for age, race, systolic blood pressure (SBP), high sensitivity C-reactive protein (hs-CRP), triglycerides (TGs), high density lipoprotein cholesterol (HDL-C), and fasting blood glucose to evaluate whether BMI or WC were an independent predictor for the presence of CAC (CAC score >0).
Results (Table): CAC was present in 60% (n = 507). Adjusting for age, race, SBP, and hs-CRP; each 1 standard deviation (SD) increase in BMI (4.6 Kg/m2) was associated with a 29% increase in the likelihood for presence of CAC (OR 1.29, 95% CI 1.08-1.54). The association between BMI and CAC was not attenuated after further adjusting for metabolic parameters [TGs, HDL-C, and fasting blood glucose] (OR 1.26, 95% CI 1.04-1.52). Associations were less robust when WC was used (OR 1.21, 95% CI 1.00-1.48) and were attenuated after adjusting for metabolic parameters (OR 1.18, 95% CI 0.96-1.47). When BMI and WC were included in the same model, BMI remained a borderline significant predictor of CAC, whereas WC did not. Analyses using BMI as a categorical variable indicated the association was significantly higher for players with BMI ≥ 40 Kg/m2 (OR 2.24, 95% CI 1.39-3.6 compared to those with BMI <40 Kg/m2).
Conclusion: Elevated BMI is independently associated with CAC in retired NFL players. The association is independent of metabolic parameters and is stronger at very high BMI levels (≥40 Kg/m2).
- © 2011 by American Heart Association, Inc.