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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(6):974-974.   Published online November 22, 2021
DOI: https://doi.org/10.4093/dmj.2021.0304
Corrects: Diabetes Metab J 2021;45(2):219
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Original Article
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
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  • 255 Download
  • 8 Web of Science
  • 5 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   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  
  • 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

Diabetes Metab J : Diabetes & Metabolism Journal