Abstract 18435: Normal Body Mass Index Does Not Protect From Coronary Atherosclerosis in the Metabolic Syndrome
Background: Obesity is a known risk factor for coronary atherosclerotic disease, but epidemiological data suggest that it may not additionally contribute to mortality in people with the metabolic syndrome (MetS). We hypothesized that people with normal weight (NW) plus MetS are at greater likelihood for having coronary artery calcium (CAC) than NW without MetS and are as likely to have CAC as those with MetS who are overweight (OW) and/or obese (OB).
Methods: We evaluated CAC scores (by Agatston units) from computed tomography scans in 11,621 men, age 40-80 years, with no history of CAD from the Cooper Clinic Longitudinal Study. Subjects were divided into 6 groups according to BMI class (NW 18.5-24.9; OW 25-29.9; OB >30 kg/m2) and the presence of MetS defined by 3 or 4 metabolic risk factors, exclusive of obesity: BP >130/85 mmHg, glucose >100 mg/dL, triglycerides >150 mg/dL, and HDL-C <40 mg/dL. We summarized levels and prevalence of CAC and tested for trends across obesity levels using multiple logistic regression analyses, adjusting for age and smoking.
Results: The prevalence CAC >0 in the study population was 55.5%. The table shows median CAC score (Agatston units), CAC >0 prevalence (%), and odds ratios (OR) for CAC >0 and CAC >100 by logistic model, adjusted for age and smoking, in the six groups.
The marginal trend in prevalence of CAC > 0 across BMI groups is significant (p=0.01); however, the trend difference between those with and without MetS is not significant (p=0.773). The group with NW plus MetS has a prevalence of CAC comparable to those with OB plus MetS.
Conclusion: In persons with or without MetS the likelihood of CAC increases with BMI. Those with MetS are more likely to be OW or OB. However, NW persons with MetS appear as likely to have detectable and clinically significant CAC, or a high odds ratio for CAC, as the OW and OB with MetS. Being NW does not protect against CAC in people with MetS.
- © 2013 by American Heart Association, Inc.