Altintas Sibel, van Workum Samanta, Kok Madeleine, Joosen Ivo A P G, Versteylen Mathijs O, Nelemans Patricia J, Wildberger Joachim E, Crijns Harry J G M, Das Marco, Kietselaer Bas L J H
Department of Cardiology Maastricht University Medical Center (MUMC+) Maastricht the Netherlands.
Department of Cardiology Canisius Wilhelmina Hospital Nijmegen the Netherlands.
Obes Sci Pract. 2022 Sep 7;9(2):172-178. doi: 10.1002/osp4.636. eCollection 2023 Apr.
Obesity is associated with cardiovascular disease (CVD) and CVD mortality. However, previous reports showed a paradoxical protective effect in patients with known CVD referred as "obesity paradox". Therefore, the aim of the present study was to investigate the association of body mass index (BMI) with coronary artery calcification (CAC) in a large outpatient cardiac CT cohort.
4.079 patients who underwent cardiac CT between December 2007-May 2014 were analyzed. BMI and clinical risk factors (current smoking, diabetes mellitus type 2, family history, systolic blood pressure, lipid spectrum) were assessed. Missing values were imputed using multiple imputation. CAC extent was categorized as absent (0), mild (>0-100), moderate (>100-400) and severe (>400).
Multivariable multinomial logistic regression analysis, including all risk factors as independent variables, showed no association between BMI and CAC. Using absence of calcification as reference category, the odds ratios per unit increase in BMI were 1.01 for mild; 1.02 for moderate; and 1.00 for severe CAC (-values ≥0.103).
No statistically significant association was observed between BMI and CAC after adjustment for other risk factors.
肥胖与心血管疾病（CVD）及CVD死亡率相关。然而，既往报告显示，在已知患有CVD的患者中存在一种矛盾的保护作用，即“肥胖悖论”。因此，本研究旨在调查大型门诊心脏CT队列中体重指数（BMI）与冠状动脉钙化（CAC）之间的关联。
对2007年12月至2014年5月期间接受心脏CT检查的4079例患者进行分析。评估BMI及临床危险因素（当前吸烟、2型糖尿病、家族史、收缩压、血脂谱）。使用多重填补法填补缺失值。CAC程度分为无（0）、轻度（>0 - 100）、中度（>100 - 400）和重度（>400）。
多变量多项逻辑回归分析将所有危险因素作为自变量，结果显示BMI与CAC之间无关联。以无钙化作为参照类别，BMI每增加一个单位，轻度CAC的比值比为1.01；中度为1.02；重度为1.00（P值≥0.103）。
在对其他危险因素进行校正后，未观察到BMI与CAC之间存在统计学显著关联。
