Association of Anthropometric and CT-Based Obesity Indices with Subclinical Atherosclerosis

Figures

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  Fig.1. Anthropometric and CT-based obesity indices. (A) Waist circumference (WC) and hip circumference (HC) were measured at the umbilical level and maximal protrusion of the hip in an upright standing position, respectively. Body mass index, waist-to-hip circumference ratio, and waist-to-height ratio were calculated from height, weight, WC, and HC. (B) Abdominal adipose tissue at the L4/5 vertebral space was adopted as a CT-based obesity index. Visceral adipose tissue (VAT) was defined as the fat enclosed by the inner aspect of the abdominal wall. Subcutaneous adipose tissue (SAT) was defined as the fat outside the outer aspects of the abdominal wall, but not including that located within the muscular fascia. The VAT-to-SAT ratio and VAT-to-total adipose tissue ratio were calculated from the VAT and SAT areas.

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  Fig.2. Multivariable ordinal logistic regression describing the association of 1-SD higher obesity indices with (A) CAC and (B) AoAC. Solid circles and horizontal lines represent the odds ratios (ORs) and 95% confidence intervals (CIs) for quartiles of CAC and AoAC scores, respectively. ORs were calculated with a 1-SD increment in BMI (3.00 kg/m2), WC (8.05 cm), HC (5.44 cm), WHR (0.05), WHtR (0.05), VAT (53.7 cm2), SAT (54.1 cm2), VSR (0.37), and VTR (0.09). Model 1: adjusted for age, smoking status (current and former), alcohol drinking (current drinker or non-drinker), and CT technique (electron beam vs. multidetector row). Model 2: further adjusted for hypertension, diabetes mellitus, and dyslipidemia. Model 3: further adjusted for BMI. AoAC, aortic artery calcification; BMI, body mass index; CAC, coronary artery calcification; HC, hip circumference; SAT, subcutaneous adipose tissue; TAT, total adipose tissue; VAT, visceral adipose tissue; VSR, VAT-to-SAT ratio; VTR, VAT-to-TAT ratio; WC, waist circumference; WHtR, waist-to-height ratio; WHR, waist-to-hip circumference ratio.

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  Fig.3. Multivariable Poisson regression with robust error variance describing associations of obesity indices with AVC. Solid circles and horizontal lines indicate the relative risks (RRs) and 95% confidence intervals (CIs) for the presence of AVC, setting the cut-off point to an Agatston score of ＞0. RRs were calculated with a 1-SD increment in BMI (3.00 kg/m2), WC (8.05 cm), HC (5.44 cm), WHR (0.05), WHtR (0.05), VAT (53.7 cm2), SAT (54.1 cm2), VSR (0.37), and VTR (0.09). Model 1: adjusted for age, smoking status (current and former), alcohol drinking (current drinker or non-drinker), and CT technique (electron beam vs. multidetector row). Model 2: further adjusted for hypertension, diabetes mellitus, and dyslipidemia. Model 3: further adjusted for BMI. AVC, aortic valve calcification; BMI, body mass index; HC, hip circumference; SAT, subcutaneous adipose tissue; TAT, total adipose tissue; VAT, visceral adipose tissue; VSR, VAT-to-SAT ratio; VTR, VAT-to-TAT ratio; WC, waist circumference; WHtR, waist-to-height ratio; WHR, waist-to-hip circumference ratio.

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  Fig.4. Multivariable Poisson regression with robust error variance describing associations of obesity indices with (A) CAC and (B) AoAC. Solid circles and horizontal lines indicate the relative risks (RRs) and 95% confidence intervals (CIs) for the presence of (A) CAC and (B) AoAC, setting the cut-off point to the 80th percentile of the Agatston score. RRs were calculated with a 1-SD increment in BMI (3.00 kg/m2), WC (8.05 cm), HC (5.44 cm), WHR (0.05), WHtR (0.05), VAT (53.7 cm2), SAT (54.1 cm2), VSR (0.37), and VTR (0.09). Model 1: adjusted for age, smoking status (current and former), alcohol drinking (current drinker or non-drinker), and CT technique (electron beam vs. multidetector row). Model 2: further adjusted for hypertension, diabetes mellitus, and dyslipidemia. Model 3: further adjusted for BMI. AoAC, aortic artery calcification; BMI, body mass index; CAC, coronary artery calcification; HC, hip circumference; SAT, subcutaneous adipose tissue; TAT, total adipose tissue; VAT, visceral adipose tissue; VSR, VAT-to-SAT ratio; VTR, VAT-to-TAT ratio; WC, waist circumference; WHtR, waist-to-height ratio; WHR, waist-to-hip circumference ratio.