Association of Anthropometric and Computed Tomography-Based Obesity Indices with Anatomically Distinct Subclinical Atherosclerotic Calcifications

Abstract Background Few studies have compared the strength in the associations of anthropometric and computed tomography (CT)-based obesity indices with coronary artery calcification (CAC), aortic artery calcification (AoAC), and aortic valve calcification (AVC). Methods In healthy 931 men (mean age, 63.7 years) from a population-based cohort, we assessed cross-sectional associations of anthropometric and CT-based obesity indices with CAC, AoAC, and AVC. Anthropometric measures included body mass index (BMI), waist circumference, hip circumference, waist-to-hip circumference ratio, and waist-to-height ratio. CT images at the L4/5 level were obtained to calculate the areas of abdominal visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), total adipose tissue (TAT), VAT-to-SAT ratio (VSR), and VAT-to-TAT ratio (VTR). CAC, AoAC, and AVC were quantified using the Agatston score based on CT scanning. Results CAC, AVC, and AoAC were present in 348 (62.6%), 173 (18.6%), and 769 (82.6%) participants, respectively. In multivariable models adjusting for age, lifestyle factors, and CT types, anthropometric and CT-based obesity indices were positively associated with CAC (p < 0.01). Conversely, VAT-to-SAT ratio and VAT-to-TAT ratio were positively associated with AoAC (p < 0.01). Any obesity indices were not associated with AVC. Conclusions The strength of the associations of obesity indices with subclinical atherosclerosis varied according to the anatomically distinct atherosclerotic lesions, among healthy men.