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Obesity is associated with coronary artery stenosis independently of metabolic risk factors : The population-based SCAPIS study

Lind, Lars ; Markstad, Hanna LU ; Ahlström, Håkan ; Angerås, Oskar ; Brandberg, John ; Brunström, Mattias ; Engström, Gunnar LU ; Engvall, Jan E. ; Eriksson, Maria J. and Eriksson, Mats , et al. (2022) In Atherosclerosis 362. p.1-10
Abstract

Background and aims: Previous studies reported divergent results on whether metabolically healthy obesity is associated with increased coronary artery calcium and carotid plaques. We investigated this in a cross-sectional fashion in a large, well-defined, middle-aged population using coronary CT angiography (CCTA) and carotid ultrasound. Methods: In the SCAPIS study (50–65 years, 51% female), CCTA and carotid artery ultrasound were performed in 23,674 individuals without clinical atherosclerotic disease. These subjects were divided into six groups according to BMI (normal weight, overweight, obese) and the presence of metabolic syndrome (MetS) according to the NCEP consensus criteria. Results: The severity of coronary artery stenosis... (More)

Background and aims: Previous studies reported divergent results on whether metabolically healthy obesity is associated with increased coronary artery calcium and carotid plaques. We investigated this in a cross-sectional fashion in a large, well-defined, middle-aged population using coronary CT angiography (CCTA) and carotid ultrasound. Methods: In the SCAPIS study (50–65 years, 51% female), CCTA and carotid artery ultrasound were performed in 23,674 individuals without clinical atherosclerotic disease. These subjects were divided into six groups according to BMI (normal weight, overweight, obese) and the presence of metabolic syndrome (MetS) according to the NCEP consensus criteria. Results: The severity of coronary artery stenosis was increased in individuals with obesity without MetS compared to normal-weight individuals without MetS (OR 1.47, 95%CI 1.34–1.62; p < 0.0001), even after adjusting for non-HDL-cholesterol and several lifestyle factors. Such difference was not observed for the presence of carotid artery plaques (OR 0.94, 95%CI 0.87–1.02; p = 0.11). Obese or overweight individuals without any MetS criteria (except the waist criterion) showed significantly more pronounced stenosis in the coronary arteries as compared to the normal-weight individuals, while one criterion was needed to show increased plaque prevalence in the carotid arteries. High blood pressure was the most important single criterion for increased atherosclerosis in this respect. Conclusions: Individuals with obesity without MetS showed increased severity of coronary artery stenosis, but no increased occurrence of carotid artery plaques compared to normal-weight individuals without MetS, further emphasizing that obesity is not a benign condition even in the absence of MetS.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atherosclerosis, Carotid artery, Coronary arteries, Epidemiology, Metabolic syndrome, Obesity
in
Atherosclerosis
volume
362
pages
10 pages
publisher
Elsevier
external identifiers
  • pmid:36356325
  • scopus:85141684329
ISSN
0021-9150
DOI
10.1016/j.atherosclerosis.2022.10.007
language
English
LU publication?
yes
id
24d13084-0902-4d98-bd55-e70dfeedf805
date added to LUP
2022-12-05 10:56:38
date last changed
2024-04-18 15:43:34
@article{24d13084-0902-4d98-bd55-e70dfeedf805,
  abstract     = {{<p>Background and aims: Previous studies reported divergent results on whether metabolically healthy obesity is associated with increased coronary artery calcium and carotid plaques. We investigated this in a cross-sectional fashion in a large, well-defined, middle-aged population using coronary CT angiography (CCTA) and carotid ultrasound. Methods: In the SCAPIS study (50–65 years, 51% female), CCTA and carotid artery ultrasound were performed in 23,674 individuals without clinical atherosclerotic disease. These subjects were divided into six groups according to BMI (normal weight, overweight, obese) and the presence of metabolic syndrome (MetS) according to the NCEP consensus criteria. Results: The severity of coronary artery stenosis was increased in individuals with obesity without MetS compared to normal-weight individuals without MetS (OR 1.47, 95%CI 1.34–1.62; p &lt; 0.0001), even after adjusting for non-HDL-cholesterol and several lifestyle factors. Such difference was not observed for the presence of carotid artery plaques (OR 0.94, 95%CI 0.87–1.02; p = 0.11). Obese or overweight individuals without any MetS criteria (except the waist criterion) showed significantly more pronounced stenosis in the coronary arteries as compared to the normal-weight individuals, while one criterion was needed to show increased plaque prevalence in the carotid arteries. High blood pressure was the most important single criterion for increased atherosclerosis in this respect. Conclusions: Individuals with obesity without MetS showed increased severity of coronary artery stenosis, but no increased occurrence of carotid artery plaques compared to normal-weight individuals without MetS, further emphasizing that obesity is not a benign condition even in the absence of MetS.</p>}},
  author       = {{Lind, Lars and Markstad, Hanna and Ahlström, Håkan and Angerås, Oskar and Brandberg, John and Brunström, Mattias and Engström, Gunnar and Engvall, Jan E. and Eriksson, Maria J. and Eriksson, Mats and Gottsäter, Anders and Hagström, Emil and Krachler, Benno and Lampa, Erik and Mannila, Maria and Nilsson, Peter M. and Nyström, Fredrik H. and Persson, Anders and Redfors, Björn and Sandström, Anette and Themudo, Raquel and Völz, Sebastian and Ärnlöv, Johan and Östgren, Carl Johan and Bergström, Göran}},
  issn         = {{0021-9150}},
  keywords     = {{Atherosclerosis; Carotid artery; Coronary arteries; Epidemiology; Metabolic syndrome; Obesity}},
  language     = {{eng}},
  pages        = {{1--10}},
  publisher    = {{Elsevier}},
  series       = {{Atherosclerosis}},
  title        = {{Obesity is associated with coronary artery stenosis independently of metabolic risk factors : The population-based SCAPIS study}},
  url          = {{http://dx.doi.org/10.1016/j.atherosclerosis.2022.10.007}},
  doi          = {{10.1016/j.atherosclerosis.2022.10.007}},
  volume       = {{362}},
  year         = {{2022}},
}