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Cited by 4Cardiac Imaging and DiagnosticsPhysical Activity and HealthObesity, Physical Activity, Diet

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Joint Associations of Obesity and Cardiorespiratory Fitness With Coronary Artery Calcium Composition: IS THERE EVIDENCE FOR FAT-BUT-FIT?

Open access
Jae, Sae Young, Kim, Hyun Jeong, Lee, Kyung Hyun, Kunutsor, Setor K., Heffernan, Kevin S., Choi, Yoon-Ho, Kang, Mira·2022·Journal of Cardiopulmonary Rehabilitation and Prevention
DOI 10.1097/hcr.0000000000000631
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Abstract

Introduction: The purpose of this study was to examine the individual and joint associations of obesity and cardiorespiratory fitness (CRF) with indices of coronary artery calcification (CAC) in 2090 middle-aged men. Methods: Obesity was defined as a body mass index (BMI) ≥25 kg/m 2 and a waist circumference (WC) ≥90 cm. Cardiorespiratory fitness was operationally defined as peak oxygen uptake (V˙o 2peak) directly measured using gas analysis. Participants were then divided into unfit and fit categories based on age-specific V˙o 2peak percentiles. Agatston scores >100 and volume and density scores >75th percentile were defined as indices of CAC, signifying advanced subclinical atherosclerosis. Results: Obese men had increased CAC Agatston, volume, and density scores, while higher CRF was associated with lower Agatston and volume scores after adjusting for potential confounders. In the joint analysis, unfit-obese men had higher CAC Agatston and CAC volume. The fit-obesity category was not associated with CAC Agatston (OR = 0.91: 95% CI, 0.66-1.25, for BMI and OR = 1.21: 95% CI, 0.86-1.70, for WC) and CAC volume (OR = 1.14: 95% CI, 0.85-1.53, for BMI and OR = 1.23: 95% CI, 0.90-1.69, for WC), which were similar to estimates for the fit-normal weight category. Conclusions: These findings demonstrate that while obesity is positively associated with the prevalence of moderate to severe CAC scores, CRF is inversely associated with the prevalence of moderate to severe CAC scores. Additionally, the combination of being fit and obese was not associated with CAC scores, which could potentially reinforce the fat-but-fit paradigm.

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Crossref · 10.1097/hcr.0000000000000631

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  • Better mortality outcomes in persons with overweight or obesity may occur in certain race-ethnicity-sex-age strata, termed the fat but fit paradigm or obesity paradox.

    “Termed by some observers as the “fat but fit” paradigm or an “obesity paradox”, better mortality outcomes in persons with overweight or obesity may occur in certain race-ethnicity-sex-age strata [47,48], and fitness level must be considered while assessing the association between body weight and medical outcomes [49].”

    From Advantages and Limitations of the Body Mass Index (BMI) to Assess Adult Obesity (2024) · cites this paper as [47]

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Research works printed but not linked: 29

  1. Reis, 2013, Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery calcification in middle age, JAMA, 310, 280, 10.1001/jama.2013.7833 · DOI
  2. Ortega, 2018, Role of physical activity and fitness in the characterization and prognosis of the metabolically healthy obesity phenotype: a systematic review and meta-analysis, Prog Cardiovasc Dis, 61, 190, 10.1016/j.pcad.2018.07.008 · DOI
  3. Kaminsky, 2019, Cardiorespiratory fitness and cardiovascular disease—the past, present, and future, Prog Cardiovasc Dis, 62, 86, 10.1016/j.pcad.2019.01.002 · DOI
  4. Lavie, 2019, Sedentary behavior, exercise, and cardiovascular health, Circ Res, 124, 799, 10.1161/CIRCRESAHA.118.312669 · DOI
  5. Lee, 2009, Does physical activity ameliorate the health hazards of obesity, Br J Sports Med, 43, 49, 10.1136/bjsm.2008.054536 · DOI · Paper page
  6. Grundy, 2012, Cardiorespiratory fitness and metabolic risk, Am J Cardiol, 109, 988, 10.1016/j.amjcard.2011.11.031 · DOI
  7. Greenland, 2018, Coronary calcium score and cardiovascular risk, J Am Coll Cardiol, 72, 434, 10.1016/j.jacc.2018.05.027 · DOI
  8. Chang, 2014, Metabolically-healthy obesity and coronary artery calcification, J Am Coll Cardiol, 63, 2679, 10.1016/j.jacc.2014.03.042 · DOI
  9. Lee, 2009, Cardiorespiratory fitness and coronary artery calcification in young adults: the CARDIA Study, Atherosclerosis, 203, 263, 10.1016/j.atherosclerosis.2008.06.012 · DOI
  10. Jae, 2016, Relation of cardiorespiratory fitness to risk of subclinical atherosclerosis in men with cardiometabolic syndrome, Am J Cardiol, 118, 1282, 10.1016/j.amjcard.2016.07.064 · DOI
  11. Sung, 2012, Prevalence of coronary atherosclerosis in asymptomatic middle-age men with high aerobic fitness, Am J Cardiol, 109, 839, 10.1016/j.amjcard.2011.11.009 · DOI · Paper page
  12. Criqui, 2014, Calcium density of coronary artery plaque and risk of incident cardiovascular events, JAMA, 311, 271, 10.1001/jama.2013.282535 · DOI · Paper page
  13. Criqui, 2020, The importance of coronary artery calcium density, JAMA Cardiol, 5, 290, 10.1001/jamacardio.2019.5745 · DOI
  14. Kokkinos, 2018, Cardiorespiratory fitness and health outcomes: a call to standardize fitness categories, Mayo Clin Proc, 93, 333, 10.1016/j.mayocp.2017.10.011 · DOI · Paper page
  15. Callister, 1998, Coronary artery disease: improved reproducibility of calcium scoring with an electron-beam CT volumetric method, Radiology, 208, 807, 10.1148/radiology.208.3.9722864 · DOI
  16. Franklin, 2020, The Journal of Cardiopulmonary Rehabilitation and Prevention at 40 yr and its role in promoting preventive cardiology: part 2, J Cardiopulm Rehabil Prev, 40, 209, 10.1097/HCR.0000000000000523 · DOI
  17. Pletcher, 2004, Using the coronary artery calcium score to predict coronary heart disease events: a systematic review and meta-analysis, Arch Intern Med, 164, 1285, 10.1001/archinte.164.12.1285 · DOI
  18. Greenland, 2004, Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals, JAMA, 291, 210, 10.1001/jama.291.2.210 · DOI
  19. Park, 2016, Waist circumference as a marker of obesity is more predictive of coronary artery calcification than body mass index in apparently healthy Korean adults: the Kangbuk Samsung Health Study, Endocrinol Metab (Seoul), 31, 559, 10.3803/EnM.2016.31.4.559 · DOI
  20. Thomas, 2018, Association of cardiovascular disease risk factors with coronary artery calcium volume versus density, Heart, 104, 135, 10.1136/heartjnl-2017-311536 · DOI
  21. Shaikh, 2019, Coronary artery calcification and ethnicity, J Cardiovasc Comput Tomogr, 13, 353, 10.1016/j.jcct.2018.10.002 · DOI
  22. DeFina, 2019, Association of all-cause and cardiovascular mortality with high levels of physical activity and concurrent coronary artery calcification, JAMA Cardiol, 4, 174, 10.1001/jamacardio.2018.4628 · DOI · Paper page
  23. Kermott, 2019, Cardiorespiratory fitness and coronary artery calcification in a primary prevention population, Mayo Clin Proc Innov Qual Outcomes, 3, 122, 10.1016/j.mayocpiqo.2019.04.004 · DOI
  24. Yoshikawa, 2013, Association of cardiorespiratory fitness with characteristics of coronary plaque: assessment using integrated backscatter intravascular ultrasound and optical coherence tomography, Int J Cardiol, 162, 123, 10.1016/j.ijcard.2011.05.047 · DOI · Paper page
  25. Thomas, 2020, Associations of recreational and non-recreational physical activity with coronary artery calcium density vs. volume and cardiovascular disease events: the Multi-Ethnic Study of Atherosclerosis, Eur Heart J Cardiovasc Imaging, 21, 132, 10.1093/ehjci/jez271 · DOI
  26. Lavie, 2014, Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox, J Am Coll Cardiol, 63, 1345, 10.1016/j.jacc.2014.01.022 · DOI
  27. Khan, 2021, Absence of an obesity paradox in patients with heart failure with reduced ejection fraction participating in phase II cardiac rehabilitation, J Cardiopulm Rehabil Prev, 41, 288, 10.1097/HCR.0000000000000595 · DOI
  28. Hamer, 2010, Cardiorespiratory fitness and metabolic risk factors in obesity, Curr Opin Lipidol, 21, 1, 10.1097/MOL.0b013e328331dd21 · DOI
  29. Bouchard, 1986, Aerobic performance in brothers, dizygotic and monozygotic twins, Med Sci Sports Exerc, 18, 639, 10.1249/00005768-198612000-00006 · DOI · Paper page

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Metadata

Authors
Jae, S. Y., Kim, H. J., Lee, K. H., Kunutsor, S. K., Heffernan, K. S., Choi, Y.-H., & Kang, M.
Affiliations
University of Seoul (KR)
Corresponding author
Jae, Sae Young
ORCID
Venue
Journal of Cardiopulmonary Rehabilitation and Prevention
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-02-08
Volume
42
Issue
3
Pages
202-207
ISSN
1932-7501 (ISSN-L)
DOI
10.1097/hcr.0000000000000631
OpenAlex
W3217767575
Cited by
4
References
6
Citations by year
2025: 2 · 2024: 2
FWCI
0.57
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Journal of Cardiopulmonary Rehabilitation and Prevention (publishedVersion)
  • PubMed (publishedVersion)
  • Explore Bristol Research (publishedVersion)
  • Bristol Research (University of Bristol) (acceptedVersion)
  • Figshare (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
obesity, cardiorespiratory fitness, coronary artery calcification, subclinical atherosclerosis, peak oxygen uptake, waist circumference, body mass index, middle-aged men, Agatston score
MeSH terms
Cardiorespiratory Fitness, Calcium, Coronary Artery Disease, Coronary Vessels, Humans, Male, Middle Aged, Obesity, Risk Factors, Body Mass Index

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