title: Fasting glucose, obesity, and coronary artery calcification in community-based people without diabetes.
abstract: OBJECTIVE
  Our objective was to assess whether impaired fasting glucose (IFG) and obesity are independently related to coronary artery calcification (CAC) in a community-based population.
  
  
  METHODS
  We assessed CAC using multidetector computed tomography in 3,054 Framingham Heart Study participants (mean [SD] age was 50 [10] years, 49% were women, 29% had IFG, and 25% were obese) free from known vascular disease or diabetes. We tested the hypothesis that IFG (5.6-6.9 mmol/L) and obesity (BMI ≥30 kg/m(2)) were independently associated with high CAC (>90th percentile for age and sex) after adjusting for hypertension, lipids, smoking, and medication.
  
  
  RESULTS
  High CAC was significantly related to IFG in an age- and sex-adjusted model (odds ratio 1.4 [95% CI 1.1-1.7], P = 0.002; referent: normal fasting glucose) and after further adjustment for obesity (1.3 [1.0-1.6], P = 0.045). However, IFG was not associated with high CAC in multivariable-adjusted models before (1.2 [0.9-1.4], P = 0.20) or after adjustment for obesity. Obesity was associated with high CAC in age- and sex-adjusted models (1.6 [1.3-2.0], P < 0.001) and in multivariable models that included IFG (1.4 [1.1-1.7], P = 0.005). Multivariable-adjusted spline regression models suggested nonlinear relationships linking high CAC with BMI (J-shaped), waist circumference (J-shaped), and fasting glucose.
  
  
  CONCLUSIONS
  In this community-based cohort, CAC was associated with obesity, but not IFG, after adjusting for important confounders. With the increasing worldwide prevalence of obesity and nondiabetic hyperglycemia, these data underscore the importance of obesity in the pathogenesis of CAC.
authors: University of Manchester, Manchester, UK. martin.rutter@manchester.ac.uk
authors: Martin K
authors: MK
authors: Rutter
authors: Joseph M
authors: JM
authors: Massaro
authors: Udo
authors: U
authors: Hoffmann
authors: Christopher J
authors: CJ
authors: O'Donnell
authors: Caroline S
authors: CS
authors: Fox
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002114:Calcinosis / Q000097:blood* / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood* / Q000378:metabolism; D003920:Diabetes Mellitus; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000378:metabolism
chemical_list: D001786:Blood Glucose