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Differential association between obesity and coronary artery disease according to the presence of diabetes in a Korean population

 Ki Bum Won  ;  Hyuk Jae Chang  ;  Hiroyuki Niinuma  ;  Jimin Sung  ;  In Jeong Cho  ;  Chi Young Shim  ;  Geu Ru Hong  ;  Young Jin Kim  ;  Byung Wook Choi  ;  Namsik Chung 
Journal Title
Issue Date
Cardiac computed tomographic angiography ; Coronary artery disease ; Diabetes ; Obesity
BACKGROUND: Coronary artery disease (CAD) is a major cardiovascular complication in diabetic patients. Despite the significant association between obesity and diabetes, the majority of the diabetic subjects are not obese in an Asian population. This study evaluated the association between obesity and coronary artery disease (CAD) according to the diabetes status in a Korean population. METHODS: The association between obesity and CAD using the parameters of any plaque, obstructive plaque, and coronary artery calcium score (CACS) >100 according to the presence of diabetes was evaluated in 7,234 Korean adults who underwent multi-detector computed tomography for general health evaluations. Obesity was defined as a body mass index (BMI) ≥25 kg/m(2). RESULTS: The prevalence of obesity was significantly higher in diabetic subjects than in non-diabetic subjects, but the majority of the diabetic subjects were non-obese (48% vs. 37%, p <0.001). The incidence of any plaque (58% vs. 29%), obstructive plaque (20% vs. 6%), and CACS >100 (20% vs. 6%) were significantly higher in diabetic patients than in non-diabetic subjects (p <0.001, respectively). Incidence of any plaque (33% vs. 26%, p <0.001), obstructive plaque (7% vs. 6%, p = 0.014), and CACS >100 (8% vs. 6%, p = 0.002) was significantly higher in non-diabetic subjects with obesity than in those without obesity, but the incidence of all coronary parameters was not different in diabetic subjects according to the obesity status. After adjusting for confounding risk factors including age, gender, hypertension, dyslipidemia, current smoking, and mild renal dysfunction, obesity was independently associated with increased risks of any plaque (OR 1.14) and CACS >100 (OR 1.31) only in non-diabetic subjects (p <0.05, respectively). Multiple logistic regression models revealed that diabetes was independently associated with all coronary parameters. CONCLUSION: Despite a significantly higher prevalence of obesity in diabetic subjects than in non-diabetic subjects, obesity is associated with the presence of any plaque and severe coronary calcification only in subjects without established diabetes among Korean population.
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5. Research Institutes (연구소) > Yonsei Cardiovascular Research Institute (심혈관연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Sung, Ji Min(성지민)
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Won, Ki Bum(원기범)
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Cho, In Jeong(조인정)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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