Background: Coronary artery disease (CAD) is a major cardiovascular complication in diabetic patients. Despite the\nsignificant association between obesity and diabetes, the majority of the diabetic subjects are not obese in an Asian\npopulation. This study evaluated the association between obesity and coronary artery disease (CAD) according to\nthe diabetes status in a Korean population.\nMethods: The association between obesity and CAD using the parameters of any plaque, obstructive plaque, and\ncoronary artery calcium score (CACS) >100 according to the presence of diabetes was evaluated in 7,234 Korean\nadults who underwent multi-detector computed tomography for general health evaluations. Obesity was defined\nas a body mass index (BMI) ?25 kg/m2.\nResults: The prevalence of obesity was significantly higher in diabetic subjects than in non-diabetic subjects, but the\nmajority of the diabetic subjects were non-obese (48% vs. 37%, p <0.001). The incidence of any plaque (58% vs. 29%),\nobstructive plaque (20% vs. 6%), and CACS >100 (20% vs. 6%) were significantly higher in diabetic patients than\nin non-diabetic subjects (p <0.001, respectively). Incidence of any plaque (33% vs. 26%, p <0.001), obstructive\nplaque (7% vs. 6%, p = 0.014), and CACS >100 (8% vs. 6%, p = 0.002) was significantly higher in non-diabetic subjects\nwith obesity than in those without obesity, but the incidence of all coronary parameters was not different in diabetic\nsubjects according to the obesity status. After adjusting for confounding risk factors including age, gender,\nhypertension, dyslipidemia, current smoking, and mild renal dysfunction, obesity was independently associated\nwith increased risks of any plaque (OR 1.14) and CACS >100 (OR 1.31) only in non-diabetic subjects (p <0.05,\nrespectively). Multiple logistic regression models revealed that diabetes was independently associated with all coronary\nparameters.\nConclusion: Despite a significantly higher prevalence of obesity in diabetic subjects than in non-diabetic subjects,\nobesity is associated with the presence of any plaque and severe coronary calcification only in subjects without\nestablished diabetes among Korean population.
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