title: Metabolic health is more closely associated with coronary artery calcification than obesity.
abstract: BACKGROUND
  Recent studies have suggested that metabolic health may contribute more to the atherosclerosis than obesity. The aim of this study is to compare coronary artery calcium scores (CACS) among patients with different metabolic health and obesity status.
  
  
  METHODS
  A health-screening program of 24,063 participants (mean age 41 years) was conducted, and CACS was assessed by multi-detector computerized tomography (MDCT). Being metabolically healthy was defined as having fewer than two of the following risk factors: high blood pressure, high fasting blood glucose, high triglyceride, low high-density lipoprotein cholesterol, highest decile of homeostasis model assessment-insulin resistance (HOMA-IR) index, and highest decile of high-sensitivity C-reactive protein (hs-CRP). Obesity status was defined as body mass index (BMI) higher than 25 kg/m(2). Analyses were performed in four groups divided according to metabolic health and obesity: metabolically healthy non-obese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUHNO), and metabolically unhealthy obese (MUHO).
  
  
  RESULTS
  Mean values of CACS in the four groups were significantly different, except those between MHNO and MHO and between MUHNO and MUHO. When multinomial logistic regression analysis was performed with five CACS categories as the dependent variables and after adjusting for age, sex, and smoking status, the MHO, MUHNO, and MUHO groups showed significantly increased odds ratio for increasing CACS categories compared with no calcification status (5.221 for CACS >400 in MUHO group with 95% CI 2.856∼5.032 with MHNO group as the reference). When other variables including the metabolic parameters were included in the same model, the risks were attenuated.
  
  
  CONCLUSIONS
  Metabolic health is more closely associated with subclinical atherosclerosis than obesity as assessed by CACS.
authors.affiliation: Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Rhee
authors.forename: Mi Hae
authors.initials: MH
authors.lastname: Seo
authors.forename: Jong Dae
authors.initials: JD
authors.lastname: Kim
authors.forename: Won Seon
authors.initials: WS
authors.lastname: Jeon
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.forename: Cheol-Young
authors.initials: CY
authors.lastname: Park
authors.forename: Ki-Won
authors.initials: KW
authors.lastname: Oh
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D008076:Cholesterol, HDL / Q000097:blood; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D014055:Tomography, Emission-Computed; D036542:Tomography, Spiral Computed; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein
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