Journal List > Korean Circ J > v.38(1) > 1016341

Kim, Choi, Choi, Suh, Lee, Kim, Yoon, Chung, and Oh: Distribution of Coronary Artery Calcification in an Asymptomatic Korean Population: Association with Risk Factors of Cardiovascular Disease and Metabolic Syndrome

Abstract

Background and Objectives

Coronary artery calcification (CAC) has been used as surrogate marker for coronary atherosclerosis. We developed a set of age-and gender-stratified CAC distribution and risk factors for CAC in a population of asymptomatic Korean subjects.

Subjects and Methods

Between 2003 and 2007, 3,961 asymptomatic subjects without a history of ischemic heart disease (male 64%, mean age 56±10 years) were screened for CAC by the use of multi-detector computed tomography.

Results

The total CAC score was assigned to a percentile according to age and gender. The prevalence of CAC and mean CAC score increased with age [p<0.001 by analysis of variance (ANOVA)]. The prevalence of CAC (mean CAC score) was 36.2% (60.5±236.1) in males, and 17.0% (15.1±84.0) in females. The age-and sex-adjusted odds ratio for the presence of CAC for subjects with diabetes was 1.542 [95% confidence interval (CI) 1.252-1.899], for subjects with hypertension was 1.673 (95% CI 1.430-1.956), for subjects with metabolic syndrome was 1.727 (95% CI 1.461-2.042), and for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥90 cm in males; ≥80 cm in females) was 1.445 (95% CI 1.222-1.709).

Conclusion

This study reports the distribution of CAC score by age and gender. It will serve as a reference standard for the clinical interpretation of CAC results in the asymptomatic Korean population.

Figures and Tables

Table 1
Baseline characteristics of study population
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Data are presented as mean±SD when appropriate. Hypercholesterolemia defined as total cholesterol ≥240 mg/dL or LDL-cholesterol ≥160 mg/dL. Impaired fasting glucose defined as fasting plasma glucose of 100 to 125 mg/dL; percentage is based on those without diabetes. Multiple risk factors identified by 2 of the following: diabetes mellitus, hypertension, hypercholesterolemia, current smoking. Metabolic syndrome identified by 3 of the following: Abdominal obesity (increased waist circumference: men ≥90 cm, women ≥80 cm), High TG ≥150 mg/dL, Low HDL-cholesterol (men, <40 mg/dL, women, <50 mg/dL), High blood pressure (≥130/85 mmHg), High fasting plasma glucose, ≥100 mg/dL. BMI: body mass index, LDL-cholesterol: low density lipoprotein cholesterol, HDL-cholesterol: high density lipoprotein cholesterol, hs-CRP: high sensitive C-reactive protein, CAC: coronary artery calcification

Table 2
Coronary artery calcium score in asymptomatic men (n=2,558) and women (n=1,403) within each age strata
kcj-38-29-i002
Table 3
Multivariable-adjusted odds ratios for coronary artery calcium with metabolic risk factors
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Abdominal obesity: waist circumference >90 cm in male; >80 cm in female. BMI: body mass index, OR: odds ratio, CI: confidence interval, FBS: fasting blood sugar, TG: triglyceride, HDL-chol: high density lipoprotein cholesterol, BP: blood pressure

Table 4
Multivariable-adjusted odds ratios for coronary artery calcium with metabolic risk factors in asymptomatic men and women
kcj-38-29-i004

*Adjusted for age, and BMI (women only). MV: multivariable, OR: odds ratio, CI: confidence interval, FBS: fasting blood sugar, TG: triglyceride, HDL-chol: high density lipoprotein cholesterol, BP: blood pressure, BMI: body mass index

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