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Diabetes and Vascular Disease Research
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Double-edged relationship between adiposity and coronary artery calcification in type 1 diabetes

Baqiyyah Conway

Department of Epidemiology, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, PA, US.

Rachel G Miller

Department of Epidemiology, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, PA, US.

Tina Costacou

Department of Epidemiology, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, PA, US.

Linda Fried

University of Pittsburgh School of Medicine, VA Pittsburgh Healthcare System, Pittsburgh, PA, US.

Sheryl Kelsey

Department of Epidemiology, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, PA, US.

Rhobert W Evans

Department of Epidemiology, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, PA, US.

Daniel Edmundowicz

University of Pittsburgh Medical Center, Pittsburgh, PA, US.

Trevor J Orchard

Department of Epidemiology, Graduate School of Public Health, The University of Pittsburgh, Pittsburgh, PA, US.

Coronary artery disease (CAD), a leading cause of death in type 1 diabetes (T1D), often occurs two or more decades earlier in this population compared to the population without diabetes. Although CAD generally increases with adiposity, this association is unclear in T1D. In this study, we examined associations of adiposity with coronary artery calcium (CAC) in 315 individuals with T1D.

Mean age and diabetes duration were 42 and 34 years, respectively, at study entry. CAC, visceral adiposity (VAT) and subcutaneous adiposity (SAT) were determined by electron beam tomography; and BMI and waist circumference (WC) were determined.

The presence of CAC was positively associated with VAT, SAT and BMI in men (p<0.05) and with all four adiposity measures in women (p<0.05) after adjustment for age and other traditional cardiovascular risk factors. However, after adjustment, the degree of CAC was not associated with any of the four adiposity measures, with the exception of SAT in women. Women in the lowest tertile of SAT had more CAC than those in the second tertile (p<0.016).

Adiposity was positively associated with the presence of CAC, but the relationship with its severity was either inverse or non-existent. This double-edged association emphasises the complex relationship between adiposity and cardiovascular risk in diabetes.

Key Words: adiposity • coronary artery calcification • coronary artery disease • subcutaneous adiposity • type 1 diabetes mellitus • visceral adiposity

Diabetes and Vascular Disease Research, Vol. 4, No. 4, 332-339 (2007)
DOI: 10.3132/dvdr.2007.061
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