The Association of Differing Measures of Overweight and Obesity With Prevalent AtherosclerosisThe Dallas Heart Study
Raphael See, MD*,
Shuaib M. Abdullah, MD*,
Darren K. McGuire, MD, MHSc, FACC*, ,
Amit Khera, MD, MSc, FACC*,,
Mahesh J. Patel, MD*,
Jason B. Lindsey, MD*,
Scott M. Grundy, MD, PhD and
James A. de Lemos, MD, FACC*,,*
* Division of Cardiology, Department of Internal Medicine
Donald W. Reynolds Cardiovascular Clinical Research Center, the University of Texas Southwestern Medical Center, Dallas, Texas
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Figure 1 Characteristic Appearance of CAC and Aortic Plaque
A representative example of coronary artery calcium on electron beam computed tomography imaging (left) and aortic plaque on magnetic resonance imaging scanning (right). The arrows depict CAC and aortic plaque. CAC = coronary artery calcium.
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Figure 2 Univariable ORs for Prevalent CAC Across Gender-Specific Obesity Quintiles
Waist circumference (WC) and waist-to-hip ratio (WHR) were associated with a stepwise increase in the odds of prevalent coronary artery calcium (CAC) (p < 0.001 for trend), whereas a J-shaped association was seen for body mass index (BMI). HC = hip circumference; OR = odds ratio.
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Figure 3 Multivariable ORs for Prevalent CAC Across Gender-Specific Obesity Quintiles
After adjustment for age, hypertension, diabetes mellitus, current smoking, dyslipidemia, low high-density lipoprotein, and high triglycerides, only WHR remained independently associated with CAC (p < 0.001 for trend). Abbreviations as in Figure 2.
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Figure 4 Univariable ORs for Prevalent Aortic Plaque Across Gender-Specific Obesity Quintiles
A nearly 3-fold increase in odds of prevalent aortic plaque was seen in the highest quintile of WHR compared with the first quintile. Neither BMI nor WC was significantly associated with aortic plaque in univariable analyses. Abbreviations as in Figure 2.
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Figure 5 Multivariable ORs for Aortic Plaque Across Gender-Specific Obesity Quintiles
After adjustment for age, hypertension, diabetes mellitus, current smoking, dyslipidemia, low high-density lipoprotein, and high triglycerides, WHR in the fourth and fifth quintiles remained significantly associated with prevalent aortic plaque. Abbreviations as in Figure 2.
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Figure 6 Waist and Hip Circumference Interaction
Prevalent coronary artery calcium and aortic plaque in subjects stratified by measurements of hip circumference above versus equal to or below the median and by "normal" and "large" waist circumference (>88 cm for women, >102 cm for men). Blue columns = coronary artery calcium; yellow columns = aortic plaque.
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