Letter: The Relationship of Body Composition and Coronary Artery Calcification in Apparently Healthy Korean Adults (Endocrinol Metab 2013;28:33-40, Jung-Hee Yu et al.)

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Endocrinol Metab 2013;28:153-154

http://dx.doi.org/10.3803/EnM.2013.28.2.153 pISSN 2093-596X · eISSN 2093-5978

Letter

The Relationship of Body Composition and Coronary

Artery Calcification in Apparently Healthy Korean Adults

(

Endocrinol Metab

_{2013;28:33-40, Jung-Hee Yu et al.)}

Han Seok Choi

Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea

It has been demonstrated that the vascular risk associated with obesity is particularly correlated with visceral fat. Visceral fat has been shown to secrete more inflammatory cytokines than subcutaneous fat. Inflammatory cytokines, such as interleu-kin-6, tumor necrosis factor-α, macrophage chemoattractant protein-1, and resistin, induce local and generalized inflamma-tion and may also affect vascular disease [1]. The coronary ar-tery calcium score (CACS) has been shown to predict future cardiovascular events [2]. Previous studies have shown that abdominal obesity is significantly correlated with CACS [3,4]. However, since there are differences in body composition across ethnic groups, it is unclear if such associations are also present in different populations.

In this context, I read with great interest the recent article ti-tled “The Relationship of Body Composition and Coronary Artery Calcification in Apparently Healthy Korean Adults” by Yu et al. [5] published in March in the Journal. The authors clearly demonstrated that abdominal obesity as assessed by waist hip ratio is the most significant predictor for CACS in apparently healthy Korean adults. This finding is important, since this is the first demonstration of such an association in a Korean population. More interestingly, they also suggested a contrasting effect of body composition on CACS between genders. Male subjects showed a negative correlation between

lean body mass and CACS, while females showed a positive correlation between body fat mass and CACS. However, the authors did not state whether they conducted logistic regres-sion analyses separately for men and women. In my opinion, it would have added more value to their findings if they demon-strated such differences between genders after adjusting for other confounding variables. Another point that should be mentioned is that other metabolic parameters such as blood pressure, total cholesterol, and triglyceride included in the lo-gistic regression analyses were found to not be significant fac-tors for CACS. However, caution should be exercised when interpreting this result. As the authors already mentioned, de-tails on subjects’ medical history, including medication use, were not available for the analyses. It is plausible that a signif-icant proportion of the subjects were using medication to con-trol hypertension or hyperlipidemia, which may be why such metabolic parameters were found to be insignificant in the analyses.

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was re-ported.

Corresponding author: Han Seok Choi

Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, 27 Dongguk-ro, Ilsandong-gu, Goyang 410-773, Korea

Tel: +82-31-961-7137, Fax: +82-31-961-7157, E-mail: [email protected]

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Choi HS

154 REFERENCES

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2. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, Liu K, Shea S, Szklo M, Bluemke DA, O’Leary DH, Tracy R, Watson K, Wong ND, Kronmal RA. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008;358:1336-45.

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calci-fication and components of body composition in elderly men. Obesity (Silver Spring) 2006;14:1571-8.

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