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Obesity is associated with coronary artery stenosis independently of metabolic risk factors: the population-based SCAPIS study
Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden.
Center for Medical Imaging and Physiology, Skåne University Hospital Lund University, Lund, Sweden; Experimental Cardiovascular Research, Clinical Research Center, Clinical Sciences, Lund University, Malmö, Sweden.
Department of Surgical Sciences, Section of Radiology, Uppsala University, Uppsala, Sweden.
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
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2022 (Engelska)Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 362, s. 1-10Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

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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Elsevier, 2022. Vol. 362, s. 1-10
Nyckelord [en]
Atherosclerosis, Carotid artery, Coronary arteries, Epidemiology, Metabolic syndrome, Obesity
Nationell ämneskategori
Kardiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-201213DOI: 10.1016/j.atherosclerosis.2022.10.007ISI: 000884640000001PubMedID: 36356325Scopus ID: 2-s2.0-85141684329OAI: oai:DiVA.org:umu-201213DiVA, id: diva2:1719452
Forskningsfinansiär
VinnovaLunds universitetHjärt-LungfondenKnut och Alice Wallenbergs StiftelseLinköpings universitetKarolinska InstitutetUmeå universitetStockholms läns landstingVetenskapsrådetGöteborgs universitetUppsala universitetTillgänglig från: 2022-12-15 Skapad: 2022-12-15 Senast uppdaterad: 2023-05-22Bibliografiskt granskad

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Brunström, MattiasSandström, Anette

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