Fasting Glucose, Obesity, and Coronary Artery Calcification in Community-Based People Without Diabetes
Diabetes Care, 07/27/2012
Rutter MK et al. – In this community–based cohort, coronary artery calcification (CAC) was associated with obesity, but not impaired fasting glucose (IFG), after adjusting for important confounders. With the increasing worldwide prevalence of obesity and nondiabetic hyperglycemia, these data underscore the importance of obesity in the pathogenesis of CAC.Methods
- The authors assessed CAC using multidetector computed tomography in 3,054 Framingham Heart Study participants (mean [SD] age was 50  years, 49% were women, 29% had IFG, and 25% were obese) free from known vascular disease or diabetes.
- The authors tested the hypothesis that IFG (5.6–6.9 mmol/L) and obesity (BMI ≥30 kg/m2) were independently associated with high CAC (>90th percentile for age and sex) after adjusting for hypertension, lipids, smoking, and medication.
- High CAC was significantly related to IFG in an age– and sex–adjusted model (odds ratio 1.4 [95% CI 1.1–1.7], P = 0.002; referent: normal fasting glucose) and after further adjustment for obesity (1.3 [1.0–1.6], P = 0.045).
- However, IFG was not associated with high CAC in multivariable–adjusted models before (1.2 [0.9–1.4], P = 0.20) or after adjustment for obesity.
- Obesity was associated with high CAC in age– and sex–adjusted models (1.6 [1.3–2.0], P < 0.001) and in multivariable models that included IFG (1.4 [1.1–1.7], P = 0.005).
- Multivariable–adjusted spline regression models suggested nonlinear relationships linking high CAC with BMI (J–shaped), waist circumference (J–shaped), and fasting glucose.