title: Relationship Between Low Relative Muscle Mass and Coronary Artery Calcification in Healthy Adults.
abstract: Sarcopenia or low muscle mass is related to cardiovascular risk factors; however, the association between low muscle mass and subclinical atherosclerosis has been largely unexplored. We investigated whether muscle mass is related to coronary artery calcification (CAC) in a large sample of middle-aged asymptomatic adults.
  
  
  
  We performed a cross-sectional study of 31 108 asymptomatic adults without cancer, diabetes mellitus, or known cardiovascular disease who underwent a health checkup examination including cardiac tomography estimation of CAC scores between 2012 and 2013. Skeletal muscle mass index (SMI) [SMI (%)=total skeletal muscle mass (kg)/body weight (kg)×100] was estimated using a bioelectrical impedance analyzer. We assessed the relationship between SMI and CAC scores using both multivariate-adjusted Tobit models and multinomial logistic regression models. Of the 31 108 subjects, 3374 subjects (10.9%) had a CAC score 1 to 100, and 628 subjects (2.0%) had a CAC score >100. SMI was inversely associated with CAC score ratios. Specifically, in a multivariable-adjusted model adjusting for potential confounders, CAC score ratios (95% confidence intervals) of SMI for quartiles 1, 2, and 3 compared with quartile 4 were 2.27 (1.70-3.05), 1.46 (1.15-1.85), and 1.24 (0.98-1.55), respectively (P for trend <0.001). Adjusting for insulin resistance reduced the magnitude of the associations, but they remained statistically significant.
  
  
  
  Relative muscle mass was negatively associated with the prevalence of coronary calcification, supporting low muscle mass as an independent risk factor of coronary heart disease.
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Byung-Joon
authors.initials: BJ
authors.lastname: Ko
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.). sh703.yoo@gmail.com yoosoo.chang@gmail.com.
authors.forename: Yoosoo
authors.initials: Y
authors.lastname: Chang
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Hyun-Suk
authors.initials: HS
authors.lastname: Jung
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Kyung Eun
authors.initials: KE
authors.lastname: Yun
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Chan-Won
authors.initials: CW
authors.lastname: Kim
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Hye Soon
authors.initials: HS
authors.lastname: Park
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Chung
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.).
authors.forename: Hocheol
authors.initials: H
authors.lastname: Shin
authors.affiliation: From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (H.S.P.). sh703.yoo@gmail.com yoosoo.chang@gmail.com.
authors.forename: Seungho
authors.initials: S
authors.lastname: Ryu
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001823:Body Composition; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006306:Health Surveys; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D055948:Sarcopenia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D066106:Seoul / Q000453:epidemiology; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*
keywords: atherosclerosis; coronary artery disease; insulin resistance; sarcopenia; skeletal muscle