Roy Sion K, Zeb Irfan, Kadakia Jigar, Li Dong, Budoff Matthew J
Department of Medicine, Division of Cardiology, Los Angeles Biomedical Research Center at Harbor-UCLA Medical Center, Torrance, California 90502, USA.
Coron Artery Dis. 2012 Mar;23(2):113-7. doi: 10.1097/MCA.0b013e32834f1b72.
We sought to establish whether elevated BMI and body surface area (BSA), two measures of obesity, are predictors of coronary artery calcium (CAC).
We retrospectively analyzed 3172 consecutive patients who underwent calcium scoring at our center. We applied a multiple logistic regression model to estimate the independent association between BMI of at least 25 kg/m(2) and incidence of CAC with adjustment for covariates. We carried out the same analysis to find out if there is an independent association between BSA of at least 1.71 m(2) (commonly used definition for abnormally elevated BSA) and incidence of CAC. We also performed a sex subanalysis based on BMI and BSA.
There were 2105 patients in the cohort with BMI of at least 25 kg/m(2) compared with 1067 patients with BMI of less than 25 kg/m(2). After adjustment for covariates, a significant association was not found between increased BMI and incidence of CAC. In addition, no significant findings were found in the sex subanalysis. A total of 2760 patients had a BSA of at least 1.71 m(2) compared with 412 patients with BSA of less than 1.71 m(2). After adjustment for covariates, a significant association (odds ratio 2.08, 95% confidence interval 1.16-3.73, P=0.014) was found between elevated BSA and CAC incidence. There were 89 men with BSA of at least 1.9 m(2) and 2248 with BSA of at least 1.9 m(2). After adjustment for covariates, the logistic regression model showed a significant association (odds ratio 2.24, 95% confidence interval 1.19-4.21, P=0.012) between BSA of at least 1.9 m(2) and incidence of CAC.
Elevated BSA is a predictor of CAC incidence, whereas elevated BMI is not. Moreover, elevated BSA is a predictor of CAC incidence particularly in men.
我们试图确定肥胖的两项指标——体重指数（BMI）升高和体表面积（BSA）是否为冠状动脉钙化（CAC）的预测因素。
我们回顾性分析了在我们中心连续接受钙化评分的3172例患者。我们应用多元逻辑回归模型来估计BMI至少为25kg/m²与CAC发生率之间的独立关联，并对协变量进行校正。我们进行了同样的分析，以确定BSA至少为1.71m²（常用于定义BSA异常升高）与CAC发生率之间是否存在独立关联。我们还基于BMI和BSA进行了性别亚组分析。
该队列中有2105例患者BMI至少为25kg/m²，而BMI低于25kg/m²的患者有1067例。在对协变量进行校正后，未发现BMI升高与CAC发生率之间存在显著关联。此外，在性别亚组分析中未发现显著结果。共有2760例患者BSA至少为1.71m²，而BSA低于1.71m²的患者有412例。在对协变量进行校正后，发现BSA升高与CAC发生率之间存在显著关联（比值比2.08，95%置信区间1.16 - 3.73，P = 0.014）。有89名男性BSA至少为1.9m²，2248名女性BSA至少为1.9m²。在对协变量进行校正后，逻辑回归模型显示BSA至少为1.9m²与CAC发生率之间存在显著关联（比值比2.24，95%置信区间1.19 - 4.21，P = 0.012）。
BSA升高是CAC发生率的预测因素，而BMI升高则不是。此外，BSA升高是CAC发生率的预测因素，尤其在男性中。
