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- Cardiovascular Risk/Epidemiology
- Clinical Significance of Body Fat Distribution in Coronary Artery Calcification Progression in Korean Population
- Heesun Lee, Hyo Eun Park, Ji Won Yoon, Su-Yeon Choi
- Diabetes Metab J. 2021;45(2):219-230. Published online October 28, 2020
- DOI: https://doi.org/10.4093/dmj.2019.0161
- Correction in: Diabetes Metab J 2021;45(6):974
- 6,550 View
- 257 Download
- 8 Web of Science
- 7 Crossref
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Graphical Abstract
Abstract
PDF
Supplementary Material
PubReader 
ePub - Background
Although obesity differs according to ethnicity, it is globally established as a solid risk factor for cardiovascular disease. However, it is not fully understood how obesity parameters affect the progression of coronary artery calcification (CAC) in Korean population. We sought to evaluate the association of obesity-related parameters including visceral adipose tissue (VAT) measurement and CAC progression.
Methods
This retrospective observational cohort study investigated 1,015 asymptomatic Korean subjects who underwent serial CAC scoring by computed tomography (CT) with at least 1-year interval and adipose tissue measurement using non-contrast CT at baseline for a routine checkup between 2003 and 2015. CAC progression, the main outcome, was defined as a difference of ≥2.5 between the square roots of the baseline and follow-up CAC scores using Agatston units.
Results
During follow-up (median 39 months), 37.5% of subjects showed CAC progression of a total population (56.4 years, 80.6% male). Body mass index (BMI) ≥25 kg/m2, increasing waist circumferences (WC), and higher VAT/subcutaneous adipose tissue (SAT) area ratio were independently associated with CAC progression. Particularly, predominance of VAT over SAT at ≥30% showed the strongest prediction for CAC progression (adjusted hazard ratio, 2.20; P<0.001) and remained of prognostic value regardless of BMI or WC status. Further, it provided improved risk stratification of CAC progression beyond known prognosticators.
Conclusion
Predominant VAT area on CT is the strongest predictor of CAC progression regardless of BMI or WC in apparently healthy Korean population. Assessment of body fat distribution may be helpful to identify subjects at higher risk. -
Citations
Citations to this article as recorded by
- Gender-specific abdominal fat distribution and insulin resistance associated with organophosphate esters and phthalate metabolites exposure
Xiaoliu Shi, Wanyue Wang, Jiafan Feng, Xiaochun Ma, Mengting Xu, Cui Wang
Environmental Pollution.2024; 349: 123959. CrossRef - The association between C-reactive protein and coronary artery calcification: a systematic review and meta-analysis
Amirhossein Tajani, Masoumeh Sadeghi, Navid Omidkhoda, Amir Hooshang Mohammadpour, Sara Samadi, Vahid Jomehzadeh
BMC Cardiovascular Disorders.2024;[Epub] CrossRef - Visceral adipose tissue is an independent predictor and mediator of the progression of coronary calcification: a prospective sub-analysis of the GEA study
Neftali Eduardo Antonio-Villa, Juan Gabriel Juárez-Rojas, Rosalinda Posadas-Sánchez, Juan Reyes-Barrera, Aida Medina-Urrutia
Cardiovascular Diabetology.2023;[Epub] CrossRef - Deep learning-based prediction for significant coronary artery stenosis on coronary computed tomography angiography in asymptomatic populations
Heesun Lee, Bong Gyun Kang, Jeonghee Jo, Hyo Eun Park, Sungroh Yoon, Su-Yeon Choi, Min Joo Kim
Frontiers in Cardiovascular Medicine.2023;[Epub] CrossRef - Relationship between a novel non–insulin-based metabolic score for insulin resistance (METS‐IR) and coronary artery calcification
Zhenwei Wang, Xiaofang Hui, Xu Huang, Jingjie Li, Naifeng Liu
BMC Endocrine Disorders.2022;[Epub] CrossRef - Association Between Abdominal Adipose Tissue Distribution and Risk of Endometrial Cancer: A Case-Control Study
Yuan Cheng, Zhongyu Wang, Xiaoxuan Jia, Rong Zhou, Jianliu Wang
Clinical Medicine Insights: Oncology.2022; 16: 117955492211407. CrossRef - Sex differences in cardiovascular risk may be related to sex differences in diet patterns: a narrative review
A. M. Tindall, V. A. Stallings
Annals of Human Biology.2021; 48(6): 517. CrossRef
- Gender-specific abdominal fat distribution and insulin resistance associated with organophosphate esters and phthalate metabolites exposure
- Complications
- Serum Total Bilirubin Levels Provide Additive Risk Information over the Framingham Risk Score for Identifying Asymptomatic Diabetic Patients at Higher Risk for Coronary Artery Stenosis
- Jaechan Leem, Eun Hee Koh, Jung Eun Jang, Chang-Yun Woo, Jin Sun Oh, Min Jung Lee, Joon-Won Kang, Tae-Hwan Lim, Chang Hee Jung, Woo Je Lee, Joong-Yeol Park, Ki-Up Lee
- Diabetes Metab J. 2015;39(5):414-423. Published online October 22, 2015
- DOI: https://doi.org/10.4093/dmj.2015.39.5.414
- 4,262 View
- 30 Download
- 7 Web of Science
- 7 Crossref
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Abstract
PDFPubReader
Background The diagnosis of coronary artery disease (CAD) is often delayed in patients with type 2 diabetes. Serum total bilirubin levels are inversely associated with CAD. However, no studies have examined whether this can be used as a biochemical marker for identifying asymptomatic diabetic patients at higher risk for having obstructive CAD.
Methods We performed a cross-sectional study of 460 consecutive asymptomatic patients with type 2 diabetes. All patients underwent coronary computed tomographic angiography, and their serum total bilirubin levels were measured. Obstructive CAD was defined as ≥50% diameter stenosis in at least one coronary artery.
Results Serum total bilirubin tertiles showed an inverse association with the prevalence of obstructive CAD. In multivariate logistic regression analysis, the odds ratio for the highest versus the lowest tertile of total bilirubin was 0.227 (95% confidence interval [CI], 0.130 to 0.398), and an increment of 1 µmol/L in serum total bilirubin level was associated with a 14.6% decrease in obstructive CAD after adjustment for confounding variables. Receiver operating characteristic curve analysis showed that the area under the curve for the Framingham Risk Score (FRS) plus serum total bilirubin level was 0.712 (95% CI, 0.668 to 0.753), which is significantly greater than that of the FRS alone (
P =0.0028).Conclusion Serum total bilirubin level is inversely associated with obstructive CAD and provides additive risk information over the FRS. Serum total bilirubin may be helpful for identifying asymptomatic patients with type 2 diabetes who are at higher risk for obstructive CAD.
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Citations
Citations to this article as recorded by- DECREASE IN SERUM BILIRUBIN AS AN UNFAVORABLE MARKER OF CARDIOVASCULAR DISORDERS
L. M. Strilchuk, O. O. Zimba, I. B. Zhakun
Eastern Ukrainian Medical Journal.2020; 8(3): 268. CrossRef - Contemporary diagnostic algorithm for coronary artery disease: achievements and prospects
A. S. Akselrod, D. Yu. Shchekochikhin, E. S. Tebenkova, A. V. Zhelankin, D. A. Stonogina, E. A. Syrkina, S. K. Ternovoy
Kardiologiya i serdechno-sosudistaya khirurgiya.2019; 12(5): 418. CrossRef - Pharmacological actions and therapeutic potentials of bilirubin in islet transplantation for the treatment of diabetes
Qing Yao, Xue Jiang, Longfa Kou, Adelaide T. Samuriwo, He-Lin Xu, Ying-Zheng Zhao
Pharmacological Research.2019; 145: 104256. CrossRef - Evaluation of genetic effect of NOS3 and G×E interaction on the variability of serum bilirubin in a Han Chinese population
Yingshui Yao, Zhengmei Fang, Song Yang, Hailong Zhao, Yanchun Chen, Yuelong Jin, Xianghai Zhao, Lijun Zhu, Yuanrui Tian, Chong Shen
Nitric Oxide.2017; 70: 25. CrossRef - Supplementation with Phycocyanobilin, Citrulline, Taurine, and Supranutritional Doses of Folic Acid and Biotin—Potential for Preventing or Slowing the Progression of Diabetic Complications
Mark McCarty
Healthcare.2017; 5(1): 15. CrossRef - Effect of bilirubin concentration on the risk of diabetic complications: A meta-analysis of epidemiologic studies
Bo Zhu, Xiaomei Wu, Yifei Bi, Yang Yang
Scientific Reports.2017;[Epub] CrossRef - Role of Bilirubin in Diabetic Vascular Complications: Can Bilirubin Predict More than Just Liver Disease?
Jun Sung Moon
Diabetes & Metabolism Journal.2015; 39(5): 384. CrossRef
- DECREASE IN SERUM BILIRUBIN AS AN UNFAVORABLE MARKER OF CARDIOVASCULAR DISORDERS
- Diagnostic Accuracy of 64-Slice MDCT Coronary Angiography for the Assessment of Coronary Artery Disease in Korean Patients with Type 2 Diabetes
- Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won, Ihn-Ho Cho, Hyoung Woo Lee
- Diabetes Metab J. 2013;37(1):54-62. Published online February 15, 2013
- DOI: https://doi.org/10.4093/dmj.2013.37.1.54
- 3,684 View
- 29 Download
- 13 Crossref
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Abstract
PDFPubReader
Background A 64-slice multidetector computed tomography (MDCT) is well known to be a useful noninvasive form of angiography for the general population, but not for certain patients with diabetes. The aim of this study was to investigate the diagnostic accuracy and usefulness of 64-slice MDCT coronary angiography for detecting coronary artery disease in Korean patients with type 2 diabetes mellitus (T2DM).
Methods A total of 240 patients were included, 74 of whom had type 2 diabetes (M:F=40:33; 41.8±9.5 years). We compared significant coronary stenosis (>50% luminal narrowing) in MDCT with invasive coronary angiography (ICA) by segment, artery, and patient. We also evaluated the influence of obesity and coronary calcium score on MDCT accuracy.
Results Of the 4,064 coronary segments studied, 4,062 segments (T2DM=1,109) were assessed quantitatively by both MDCT and ICA, and 706 segments (T2DM=226) were detected as a significant lesion by ICA in all patients. Sensitivity, specificity, as well as positive and negative predictive values for the presence of significant stenosis in T2DM were: by segment, 89.4%, 96.4%, 85.8%, and 97.4%, respectively; by artery (
n =222), 95.1%, 92.9%, 94.4%, and 93.8%, respectively; by patients (n =74), 98.4%, 100.0%, 98.4%, and 90.0%, respectively. Regardless of presence of diabetes, there was no significant difference in diagnostic accuracy. Obesity (≥25 kg/m2) and coronary calcium score did not also affect the diagnostic accuracy of MDCT.Conclusion The 64-slice MDCT coronary angiography was found to have similar diagnostic accuracy with ICA, regardless of diabetes. These results suggest MDCT may be helpful to reduce unnecessary invasive studies for patients with diabetes.
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Citations
Citations to this article as recorded by- Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain?
Sherine M. Sharara, Scott R. Monnin, Manolo Rubio, Rami N. Khouzam, Samar R. Ragheb
Current Problems in Cardiology.2021; 46(4): 100766. CrossRef - Assessment of high sensitivity C-reactive protein and coronary plaque characteristics by computed tomography in patients with and without diabetes mellitus
Hai-Ting Zhou, De-Li Zhao, Guo-Kun Wang, Tian-Zuo Wang, Hong-Wei Liang, Jin-Ling Zhang
BMC Cardiovascular Disorders.2020;[Epub] CrossRef - Triglyceride Glucose-Waist Circumference Better Predicts Coronary Calcium Progression Compared with Other Indices of Insulin Resistance: A Longitudinal Observational Study
Yun Kyung Cho, Jiwoo Lee, Hwi Seung Kim, Eun Hee Kim, Min Jung Lee, Dong Hyun Yang, Joon-Won Kang, Chang Hee Jung, Joong-Yeol Park, Hong-Kyu Kim, Woo Je Lee
Journal of Clinical Medicine.2020; 10(1): 92. CrossRef - The impact of non-alcoholic fatty liver disease and metabolic syndrome on the progression of coronary artery calcification
Yun Kyung Cho, Yu Mi Kang, Jee Hee Yoo, Jiwoo Lee, Seung Eun Lee, Dong Hyun Yang, Joon-Won Kang, Joong-Yeol Park, Chang Hee Jung, Hong-Kyu Kim, Woo Je Lee
Scientific Reports.2018;[Epub] CrossRef - Effects of Low-density Lipoprotein Cholesterol on Coronary Artery Calcification Progression According to High-density Lipoprotein Cholesterol Levels
Da Young Lee, Ji Hyun Kim, Se Eun Park, Cheol-young Park, Ki-won Oh, Sung-woo Park, Eun-Jung Rhee, Won-young Lee
Archives of Medical Research.2017; 48(3): 284. CrossRef - 2013 ACC/AHA Cholesterol Guideline Versus 2004 NCEP ATP III Guideline in the Prediction of Coronary Artery Calcification Progression in a Korean Population
Yun Kyung Cho, Chang Hee Jung, Yu Mi Kang, Jenie Yoonoo Hwang, Eun Hee Kim, Dong Hyun Yang, Joon‐Won Kang, Joong‐Yeol Park, Hong‐Kyu Kim, Woo Je Lee
Journal of the American Heart Association.2016;[Epub] CrossRef - Imaging Quality Evaluation of Low Tube Voltage Coronary CT Angiography Using Low Concentration Contrast Medium
Chengzhong Zhang, Yuejun Yu, Zaixian Zhang, Qingguo Wang, Linfeng Zheng, Yan Feng, Zhiguo Zhou, Guixiang Zhang, Kangan Li, Zhuoli Zhang
PLOS ONE.2015; 10(3): e0120539. CrossRef - 2013 ACC/AHA versus 2004 NECP ATP III Guidelines in the Assignment of Statin Treatment in a Korean Population with Subclinical Coronary Atherosclerosis
Chang Hee Jung, Min Jung Lee, Yu Mi Kang, Dong Hyun Yang, Joon-Won Kang, Eun Hee Kim, Duk-Woo Park, Joong-Yeol Park, Hong-Kyu Kim, Woo Je Lee, Yingmei Feng
PLOS ONE.2015; 10(9): e0137478. CrossRef - Serum Total Bilirubin Levels Provide Additive Risk Information over the Framingham Risk Score for Identifying Asymptomatic Diabetic Patients at Higher Risk for Coronary Artery Stenosis
Jaechan Leem, Eun Hee Koh, Jung Eun Jang, Chang-Yun Woo, Jin Sun Oh, Min Jung Lee, Joon-Won Kang, Tae-Hwan Lim, Chang Hee Jung, Woo Je Lee, Joong-Yeol Park, Ki-Up Lee
Diabetes & Metabolism Journal.2015; 39(5): 414. CrossRef - Association between serum gamma-glutamyltransferase and the progression of coronary artery calcification
Yun Kyung Cho, Yu Mi Kang, Jenie Yoonoo Hwang, Eun Hee Kim, Dong Hyun Yang, Joon-Won Kang, Joong-Yeol Park, Woo Je Lee, Hong-Kyu Kim, Chang Hee Jung
Atherosclerosis.2015; 243(1): 300. CrossRef - Role of Bilirubin in Diabetic Vascular Complications: Can Bilirubin Predict More than Just Liver Disease?
Jun Sung Moon
Diabetes & Metabolism Journal.2015; 39(5): 384. CrossRef - The Association of Rate of Weight Gain During Early Adulthood With the Prevalence of Subclinical Coronary Artery Disease in Recently Diagnosed Type 2 Diabetes: The MAXWEL-CAD Study
Soo Lim, Sung Hee Choi, Kyoung Min Kim, Sang Il Choi, Eun Ju Chun, Min Joo Kim, Kyong Soo Park, Hak Chul Jang, Naveed Sattar
Diabetes Care.2014; 37(9): 2491. CrossRef - Retraction: Diagnostic Accuracy of 64-Slice MDCT Coronary Angiography for the Assessment of Coronary Artery Disease in Korean Patients with Type 2 Diabetes
Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won, Ihn-Ho Cho, Hyoung Woo Lee
Diabetes & Metabolism Journal.2013; 37(3): 217. CrossRef
- Can Radiation Dose Burden of CT Angiography be Reduced While Still Accurately Diagnosing Etiology of Acute Chest Pain?
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