Body morphology differentially predicts coronary calcium

Objective: To test the hypothesis that three measures of body morphology would be differentially correlated with and predictive of coronary artery calcification. Design: Cross-sectional analytic study of body mass index (BMI), central adiposity ('visceral fat') and total body percent fat. Subjects: In a total of 3028 healthy, free living men and women (mean age and BMI: 56.7 and 27.0, respectively). Measurements: Coronary calcification and visceral fat (VF) content was measured using electron beam computed tomography while percent body fat (BF) was determined using bioimpedence. Results: In men, the median coronary calcium score increased from 6.7 for a BMI less than or equal to24 to 30.9 for a BMI greater than or equal to30; from 3.6 to 46.4 between the first and fourth quartile of VF; and from 1 to 97.6 for the same in BF. There were no significant increases in calcium scores in women for any of these indices. There were also no significant age-adjusted correlations between BMI, BF and VF with the extent of coronary calcium in either gender. On multivariable logistic regression analysis, men with a BMI in the third and fourth quartiles had 1.64 and 2.01 times increase in risk, respectively, for the presence of any coronary calcium compared to those in the first quartile (Pless than or equal to0.01 for both) while men in the highest quartile for VF had a 63% increase in this same risk (P=0.04). For women, a BMI in the fourth quartile was associated with a 68% increase in risk for the presence of any coronary calcium (P=0.01). Conclusion: BMI is a significant predictor of coronary calcium. In men, central adiposity is also an independent predictor. These findings lend further support to weight control for coronary disease prevention.