The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis: The Dallas Heart Study Export

@article{citeulike:4292877, abstract = {ObjectivesThis study sought to evaluate the associations between different measures of obesity and prevalent atherosclerosis in a large population-based cohort. BackgroundAlthough obesity is associated with cardiovascular mortality, it is unclear whether this relationship is mediated by increased atherosclerotic burden. MethodsUsing data from the Dallas Heart Study, we assessed the association between gender-specific obesity measures (i.e., body mass index [BMI]; waist circumference [WC]; waist-to-hip ratio [WHR]) and prevalent atherosclerosis defined as coronary artery calcium (CAC) score >10 Agatston units measured by electron-beam computed tomography and detectable aortic plaque measured by magnetic resonance imaging. ResultsIn univariable analyses (n = 2,744), CAC prevalence was significantly greater only in the fifth versus first quintile of BMI, whereas it increased stepwise across quintiles of WC and WHR (p trend <0.001 for each). After multivariable adjustment for standard risk factors, prevalent CAC was more frequent in the fifth versus first quintile of WHR (odds ratio 1.91, 95\% confidence interval 1.30 to 2.80), whereas no independent positive association was observed for BMI or WC. Similar results were observed for aortic plaque in both univariable and multivariable-adjusted analyses. The c-statistic for discrimination of prevalent CAC was greater for WHR compared with BMI and WC in women and men (p < 0.001 vs. BMI; p < 0.01 vs. WC). ConclusionsWe discovered that WHR was independently associated with prevalent atherosclerosis and provided better discrimination than either BMI or WC. The associations between obesity measurements and atherosclerosis mirror those observed between obesity and cardiovascular mortality, suggesting that obesity contributes to cardiovascular mortality via increased atherosclerotic burden. 10.1016/j.jacc.2007.04.066}, author = {See, Raphael and Abdullah, Shuaib M. and Mcguire, Darren K. and Khera, Amit and Patel, Mahesh J. and Lindsey, Jason B. and Grundy, Scott M. and de Lemos, James A.}, citeulike-article-id = {4292877}, citeulike-linkout-0 = {http://dx.doi.org/10.1016/j.jacc.2007.04.066}, day = {6}, doi = {10.1016/j.jacc.2007.04.066}, journal = {J Am Coll Cardiol}, keywords = {atherosclerosis, measures, obesity, overweight, waist-to-hip-ratio}, month = {August}, pages = {j.jacc.2007.04.066+}, posted-at = {2009-04-09 03:33:33}, priority = {2}, title = {The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis: The Dallas Heart Study}, url = {http://dx.doi.org/10.1016/j.jacc.2007.04.066}, year = {2007} }

TY - JOUR ID - citeulike:4292877 L3 - citeulike-article-id:4292877 N2 - ObjectivesThis study sought to evaluate the associations between different measures of obesity and prevalent atherosclerosis in a large population-based cohort. BackgroundAlthough obesity is associated with cardiovascular mortality, it is unclear whether this relationship is mediated by increased atherosclerotic burden. MethodsUsing data from the Dallas Heart Study, we assessed the association between gender-specific obesity measures (i.e., body mass index [BMI]; waist circumference [WC]; waist-to-hip ratio [WHR]) and prevalent atherosclerosis defined as coronary artery calcium (CAC) score >10 Agatston units measured by electron-beam computed tomography and detectable aortic plaque measured by magnetic resonance imaging. ResultsIn univariable analyses (n = 2,744), CAC prevalence was significantly greater only in the fifth versus first quintile of BMI, whereas it increased stepwise across quintiles of WC and WHR (p trend <0.001 for each). After multivariable adjustment for standard risk factors, prevalent CAC was more frequent in the fifth versus first quintile of WHR (odds ratio 1.91, 95% confidence interval 1.30 to 2.80), whereas no independent positive association was observed for BMI or WC. Similar results were observed for aortic plaque in both univariable and multivariable-adjusted analyses. The c-statistic for discrimination of prevalent CAC was greater for WHR compared with BMI and WC in women and men (p < 0.001 vs. BMI; p < 0.01 vs. WC). ConclusionsWe discovered that WHR was independently associated with prevalent atherosclerosis and provided better discrimination than either BMI or WC. The associations between obesity measurements and atherosclerosis mirror those observed between obesity and cardiovascular mortality, suggesting that obesity contributes to cardiovascular mortality via increased atherosclerotic burden. 10.1016/j.jacc.2007.04.066 JF - J Am Coll Cardiol TI - The Association of Differing Measures of Overweight and Obesity With Prevalent Atherosclerosis: The Dallas Heart Study SP - j.jacc.2007.04.066 KW - atherosclerosis KW - measures KW - obesity KW - overweight KW - waist-to-hip-ratio AU - See, Raphael AU - Abdullah, Shuaib AU - Mcguire, Darren AU - Khera, Amit AU - Patel, Mahesh AU - Lindsey, Jason AU - Grundy, Scott AU - de Lemos, James PY - 2007/08/06/ UR - http://dx.doi.org/10.1016/j.jacc.2007.04.066 ER -