{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:27:41Z","timestamp":1789820861775,"version":"4.0.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["ATVB"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec>\n            <jats:title>Objective\u2014<\/jats:title>\n            <jats:p>Sarcopenia or low muscle mass is related to cardiovascular risk factors; however, the association between low muscle mass and subclinical atherosclerosis has been largely unexplored. We investigated whether muscle mass is related to coronary artery calcification (CAC) in a large sample of middle-aged asymptomatic adults.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results\u2014<\/jats:title>\n            <jats:p>\n              We performed a cross-sectional study of 31\u2009108 asymptomatic adults without cancer, diabetes mellitus, or known cardiovascular disease who underwent a health checkup examination including cardiac tomography estimation of CAC scores between 2012 and 2013. Skeletal muscle mass index (SMI) [SMI (%)=total skeletal muscle mass (kg)\/body weight (kg)\u00d7100] was estimated using a bioelectrical impedance analyzer. We assessed the relationship between SMI and CAC scores using both multivariate-adjusted Tobit models and multinomial logistic regression models. Of the 31\u2009108 subjects, 3374 subjects (10.9%) had a CAC score 1 to 100, and 628 subjects (2.0%) had a CAC score &gt;100. SMI was inversely associated with CAC score ratios. Specifically, in a multivariable-adjusted model adjusting for potential confounders, CAC score ratios (95% confidence intervals) of SMI for quartiles 1, 2, and 3 compared with quartile 4 were 2.27 (1.70\u20133.05), 1.46 (1.15\u20131.85), and 1.24 (0.98\u20131.55), respectively (\n              <jats:italic>P<\/jats:italic>\n              for trend &lt;0.001). Adjusting for insulin resistance reduced the magnitude of the associations, but they remained statistically significant.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Relative muscle mass was negatively associated with the prevalence of coronary calcification, supporting low muscle mass as an independent risk factor of coronary heart disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/atvbaha.116.307156","type":"journal-article","created":{"date-parts":[[2016,4,1]],"date-time":"2016-04-01T03:59:11Z","timestamp":1459483151000},"page":"1016-1021","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":100,"title":["Relationship Between Low Relative Muscle Mass and Coronary Artery Calcification in Healthy Adults"],"prefix":"10.1161","volume":"36","author":[{"given":"Byung-Joon","family":"Ko","sequence":"first","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoosoo","family":"Chang","sequence":"additional","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Suk","family":"Jung","sequence":"additional","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Eun","family":"Yun","sequence":"additional","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chan-Won","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Soon","family":"Park","sequence":"additional","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design &amp; Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea (Y.C., S.R.); and Department of Family..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Chul","family":"Chung","sequence":"additional","affiliation":[{"name":"From the Center for Cohort Studies, Total Healthcare Center (B.-J.K., Y.C., H.-S.J., K.E.Y., C.-W.K., E.C.C., H.S., S.R.), Department of Occupational and Environmental Medicine (Y.C., S.R.), Department of Radiology (E.C.C.), and Department of Family Medicine (H.S.), Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; 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