Differential association between obesity and coronary artery disease according to the presence of diabetes in a Korean population

Ki Bum Won, Hyuk Jae Chang, Hiroyuki Niinuma, Jimin Sung, In Jeong Cho, Chi Young Shim, Geu Ru Hong, Young Jin Kim, Byung Wook Choi, Namsik Chung

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3 Scopus citations


Background: Coronary artery disease (CAD) is a major cardiovascular complication in diabetic patients. Despite th significant association between obesity and diabetes, the majority of the diabetic subjects are not obese in an Asia population. This study evaluated the association between obesity and coronary artery disease (CAD) according t the diabetes status in a Korean population Methods: The association between obesity and CAD using the parameters of any plaque, obstructive plaque, an coronary artery calcium score (CACS) >100 according to the presence of diabetes was evaluated in 7,234 Korea adults who underwent multi-detector computed tomography for general health evaluations. Obesity was define as a body mass index (BMI) ≥25 kg/m2 Results: The prevalence of obesity was significantly higher in diabetic subjects than in non-diabetic subjects, but th majority of the diabetic subjects were non-obese (48% vs. 37%, p <0.001). The incidence of any plaque (58% vs. 29%) obstructive plaque (20% vs. 6%), and CACS >100 (20% vs. 6%) were significantly higher in diabetic patients tha in non-diabetic subjects (p <0.001, respectively). Incidence of any plaque (33% vs. 26%, p <0.001), obstructiv plaque (7% vs. 6%, p = 0.014), and CACS >100 (8% vs. 6%, p = 0.002) was significantly higher in non-diabetic subject with obesity than in those without obesity, but the incidence of all coronary parameters was not different in diabeti subjects according to the obesity status. After adjusting for confounding risk factors including age, gender hypertension, dyslipidemia, current smoking, and mild renal dysfunction, obesity was independently associate with increased risks of any plaque (OR 1.14) and CACS >100 (OR 1.31) only in non-diabetic subjects (p <0.05 respectively). Multiple logistic regression models revealed that diabetes was independently associated with all coronar parameters Conclusion: Despite a significantly higher prevalence of obesity in diabetic subjects than in non-diabetic subjects obesity is associated with the presence of any plaque and severe coronary calcification only in subjects withou established diabetes among Korean population.

Original languageEnglish
Article number134
JournalDiabetology and Metabolic Syndrome
Issue number1
StatePublished - 2014

Bibliographical note

Funding Information:
This research was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea, funded by the Ministry of Education, Science, and Technology (2012027176).

Publisher Copyright:
© 2014 Won et al.


  • Cardiac computed tomographic angiograph
  • Coronary artery disease
  • Diabetes
  • Obesity


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