Visceral fat accumulation as a predictor of coronary artery calcium as assessed by multislice computed tomography in Japanese patients

Abstract

The impact of visceral adiposity on subclinical coronary atherosclerosis is unclear in Japanese patients. We investigated the sex-specific relationship between the amount of visceral fat and coronary artery calcium (CAC) using multislice computed tomography (MSCT). This is a cross-sectional study of 321 consecutive Japanese patients (213 men and 108 women) who underwent MSCT scanning for the examination of coronary heart disease. CAC score, visceral fat area (VFA), subcutaneous fat area (SFA), and waist circumference (WC) were determined by MSCT for all patients. The prevalence of detectable CAC was 73% and 57% in men and women, respectively. Using a multivariable logistic and ordinal regression analyses adjusting for traditional cardiovascular risk factors and adiposity measurements, VFA represented an independent predictor of the presence and extent of CAC (odds ratio (95% confidence interval) per one-unit-standard deviation increase in VFA: 2.48 (1.23–6.05) in logistic regression analysis; 2.05 (1.18–3.98) in ordinal regression analysis). Similar relationships were observed across the gender. We further assessed the sex-specific cut-off levels of VFA and WC to predict the presence of CAC. The results of receiver operator characteristic analysis indicated that the VFA cut-off level in men was 116 cm 2; and in women, it was 82 cm 2, corresponding to WC values of 87.7 cm in men and 82.6 cm in women. In conclusion, we found that visceral adiposity measured by MSCT is significantly associated with the presence and extent of CAC as a marker of subclinical atherosclerosis in Japanese patients.