title: A cross-sectional association of obesity with coronary calcium among Japanese, Koreans, Japanese Americans, and U.S. whites.
abstract: OBJECTIVE
  Conflicting evidence exists regarding whether obesity is independently associated with coronary artery calcium (CAC), a measure of coronary atherosclerosis. We examined an independent association of obesity with prevalent CAC among samples of multi-ethnic groups whose background populations have varying levels of obesity and coronary heart disease (CHD).
  
  
  RESULTS
  We analysed a population-based sample of 1212 men, aged 40-49 years free of clinical cardiovascular disease recruited in 2002-06; 310 Japanese in Japan (JJ), 294 Koreans in South Korea (KN), 300 Japanese Americans (JA), and 308 Whites in the USA (UW). We defined prevalent CAC as an Agatston score of ≥10. Prevalent CAC was calculated by tertile of the body mass index (BMI) in each ethnic group and was plotted against the corresponding median of tertile BMI. Additionally, logistic regression was conducted to examine whether an association of the BMI was independent of conventional risk factors. The median BMI and crude prevalence of CAC for JJ, KN, JA, and UW were 23.4, 24.4, 27.4, and 27.1 (kg/m2); 12, 11, 32, and 26 (%), respectively. Despite the absolute difference in levels of BMI and CAC across groups, higher BMI was generally associated with higher prevalent CAC in each group. After adjusting for age, smoking, alcohol, hypertension, lipids, and diabetes mellitus, the BMI was positively and independently associated with prevalent CAC in JJ, KN, UW, but not in JA.
  
  
  CONCLUSIONS
  In this multi-ethnic study, obesity was independently associated with subclinical stage of coronary atherosclerosis among men aged 40-49 years regardless of the BMI level.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan. afujiy@belle.shiga-med.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiyoshi
authors.forename: Akira
authors.initials: A
authors.lastname: Sekikawa
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.forename: Kamal
authors.initials: K
authors.lastname: Masaki
authors.forename: J
authors.initials: J
authors.lastname: David Curb
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.forename: Sayaka
authors.initials: S
authors.lastname: Kadowaki
authors.forename: Aya
authors.initials: A
authors.lastname: Kadota
authors.forename: Daniel
authors.initials: D
authors.lastname: Edmundowicz
authors.forename: Amber
authors.initials: A
authors.lastname: Shah
authors.forename: Rhobert W
authors.initials: RW
authors.lastname: Evans
authors.forename: Marianne
authors.initials: M
authors.lastname: Bertolet
authors.forename: Jina
authors.initials: J
authors.lastname: Choo
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Willcox
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Murata
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D003430:Cross-Sectional Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology / Q000208:ethnology; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: Body mass index; Coronary artery calcium; Men; Multi-ethnic; Obesity; Risk factors