Division of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
Eur Heart J Cardiovasc Imaging. 2019 May 1;20(5):591-599. doi: 10.1093/ehjci/jey192.
This study explored the coronary plaque volume change (PVC) according to the change of percent body mass index (BMI) and categorical BMI group using serial coronary computed tomography angiography (CCTA).
A total of 1568 subjects who underwent serial CCTA with available BMI at baseline (CCTA1) and follow-up (CCTA2) were included. Median inter-scan period was 3.3 (interquartile range: 2.6-4.6) years. Quantitative assessment of coronary plaque was performed at both scans. All participants were categorized into three BMI (kg/m2) groups: normal: <25.0; overweight: 25.0-29.9; and obesity: ≥30.0. During follow-up, there were no significant differences in annualized PVC according to the 5% change of BMI in all BMI groups. Among 1424 (90.8%) subjects in the same BMI group at CCTA1 and CCTA2, a significant difference in annualized (PVC) was observed among the three groups. In 144 (9.2%) subjects with the change in their BMI group at CCTA2 compared their results at CCTA1, annualized PVC was not different compared with subjects in the same BMI group during follow-up. The percent change of BMI was not significantly related to the annualized PVC after adjusting confounding factors. Male gender [odds ratio (OR): 1.38; 95% confidence interval (CI): 1.05-1.81; P = 0.022], baseline plaque volume (OR: 1.07; 95% CI: 1.05-1.09; P < 0.001), and baseline overweight or obesity (OR: 1.35; 95% CI: 1.04-1.77; P = 0.027) were independently associated with coronary plaque progression.
Over the near term, longitudinal small changes in BMI were not associated with changes in coronary plaque volume although baseline BMI was.
ClinicalTrials.gov NCT02803411.
本研究通过连续冠状动脉计算机断层扫描血管造影（CCTA）探讨体质量指数（BMI）变化百分比和分类 BMI 组的冠状动脉斑块体积变化（PVC）。
共纳入 1568 例连续行 CCTA 且基线（CCTA1）和随访（CCTA2）时均有 BMI 值的患者。两次扫描之间的中位间隔时间为 3.3 年（四分位距：2.6-4.6）。两次扫描均行冠状动脉斑块定量评估。所有患者分为三组 BMI（kg/m2）：正常：<25.0；超重：25.0-29.9；肥胖：≥30.0。随访期间，在所有 BMI 组中，BMI 变化 5%与 PVC 的年增长率无显著差异。在 CCTA1 和 CCTA2 时处于同一 BMI 组的 1424 例（90.8%）患者中，三组之间的年化（PVC）差异具有统计学意义。在 CCTA2 时 BMI 组发生变化的 144 例（9.2%）患者中，与 CCTA1 时的结果相比，随访期间与同组 BMI 患者相比，年化 PVC 无差异。调整混杂因素后，BMI 变化百分比与年化 PVC 无显著相关性。男性（比值比[OR]：1.38；95%置信区间[CI]：1.05-1.81；P=0.022）、基线斑块体积（OR：1.07；95%CI：1.05-1.09；P<0.001）和基线超重或肥胖（OR：1.35；95%CI：1.04-1.77；P=0.027）与冠状动脉斑块进展独立相关。
在近期，BMI 的纵向小变化与冠状动脉斑块体积的变化无关，尽管基线 BMI 与之相关。
ClinicalTrials.gov NCT02803411。
