Body fat distribution might be differentially associated with subclinical cardiovascular
disease. We examined whether the body mass index, waist circumference, and subcutaneous
and visceral adipose tissue are associated with the prevalence of either coronary
or abdominal aortic calcium in the Framingham Heart Study. Participants (n = 3,130,
mean age 52 years, 49% women) free of clinical cardiovascular disease from the Framingham
Heart Study underwent multidetector computed tomographic assessment to quantify the
subcutaneous and visceral fat volume and coronary and abdominal aortic calcification.
Coronary artery calcification and abdominal aortic calcium were examined in relation
to the body mass index, waist circumference, subcutaneous adipose tissue, and visceral
adipose tissue in age-, gender-, and multivariate-adjusted models. All measures of
adiposity were associated with coronary aortic calcium in the age- and gender-adjusted
models (all p <0.008). All relations were attenuated in the multivariate models (all
p >0.14). The body mass index, waist circumference, and visceral adipose tissue (but
not the subcutaneous adipose tissue) were associated with abdominal aortic calcification
in the age- and gender-adjusted models (all p <0.012). However, all relations were
attenuated in the multivariate models (all p >0.23). Similar findings were observed
in the quartile-based analyses. In conclusion, the general measures of obesity and
measures of central abdominal fat are related to the coronary aortic calcium and abdominal
aortic calcium levels. However, these cross-sectional associations are attenuated
by cardiovascular disease risk factors, possibly because they mediate the association
between adiposity measures and subclinical cardiovascular disease.