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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
Original Article
Korean Circulation Journal

Korean Circulation Journal 2008; 38(1): 29-35.

Published online: 31 January 2008

DOI: https://doi.org/10.4070/kcj.2008.38.1.29

Distribution of Coronary Artery Calcification in an Asymptomatic Korean Population: Association with Risk Factors of Cardiovascular Disease and Metabolic Syndrome

Donghee Kim, MD1, Su-Yeon Choi, MD1, 2, Eue-Keun Choi, MD2, Jung-Won Suh, MD1, 2, Whal Lee, MD3, Young Sun Kim, MD1, Dae Hyun Yoon, MD1, Jin-Wook Chung, MD2, Byung-Hee Oh, MD2

1Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.

2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

3Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

Correspondence: Su-Yeon Choi, MD, Seoul National University Hospital Healthcare System Gangnam Center, Department of Internal Medicine, Seoul National University College of Medicine, 39F Gangnam Finance Center, 737 Yeoksam-dong, Gangnam-gu, Seoul 135-984, Korea. Tel: 82-2-2112-5639, Fax: 82-2-2112-5635, sychoi9@yahoo.co.kr

Received 21 September 2007       Revised 31 October 2007       Accepted 1 November 2007

Copyright © 2008 The Korean Society of Cardiology

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.

Keywords: Coronary arteries, Pathologic calcification, Risk factors, Metabolic syndrome X

Figures and Tables

Table 1
Baseline characteristics of study population
kcj-38-29-i001

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
kcj-38-29-i003

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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