Comment on “The impact of visceral fat and levels of vitamin D on coronary artery calcification”

Dear Editor,

We were glad to read the interesting article entitled “The impact of visceral fat and levels of vitamin D on coronary artery calcification” written by the Rodrigues Isa Galvão¹ and his study team. The authors found that excess visceral fat was associated with subclinical atherosclerosis, regardless of other risk factors for cardiovascular disease, and that serum levels of 25-hydroxyvitamin D3 were not associated with coronary artery calcification in its early stages. Although the findings of their study offer innovative ideas and are supported by useful arguments, we consider some issues should be further discussed.

According to the categories of the World Health Organization, the definitions of overweight (body mass index [BMI]: 25–<30 kg/m²) and obese (BMI ≥30 kg/m²) are different. However, it is given in this article that overweight refers to the BMI ≥30 kg/m². In consideration of scientific rigor, this definition can be slightly modified.

In this study, logistic regression analysis was conducted to assess for confounding factor such as visceral adipose tissue, age, and hypertension. Apart from this, smoking² and drinking³ are considered high-risk factors of coronary artery calcification. In addition, tobacco nicotine and alcohol can also cause significant damage in coronary artery. Therefore, smoking and drinking should be treated as confounding variables. The age of the sample ranges from 43.5 to 68.3 years, which contains a large span. It is found that there is a certain connection between age and coronary artery calcification. Thus, it is a good idea to shorten the age span. Moreover, we cannot find references about VRT, CAD, and TAV in the whole article. We recommend that they can be explained, but if they are misspelled, they can be corrected.

• Funding: none.

REFERENCES

• ¹
  Rodrigues IG, Pinho CPS, Sobral Filho D, Leao APD, Oliveira MCM, Barbosa GP, et al. The impact of visceral fat and levels of vitamin D on coronary artery calcification. Rev Assoc Med Bras (1992). 2021;67(1):88-93. https://doi.org/10.1590/1806-9282.67.01.20200388
  » https://doi.org/10.1590/1806-9282.67.01.20200388
• ²
  Kim BJ, Han JM, Kang JG, Kim BS, Kang JH. The association between self-reported versus nicotine metabolite-confirmed smoking status and coronary artery calcification. Coron Artery Dis. 2018;29(3):254-61. https://doi.org/10.1097/MCA.0000000000000568
  » https://doi.org/10.1097/MCA.0000000000000568
• ³
  Pletcher MJ, Varosy P, Kiefe CI, Lewis CE, Sidney S, Hulley SB. Alcohol consumption, binge drinking, and early coronary calcification: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Epidemiol. 2005;161(5):423-33. https://doi.org/10.1093/aje/kwi062
  » https://doi.org/10.1093/aje/kwi062

Publication Dates

• Publication in this collection
  25 May 2022
• Date of issue
  Apr 2022

History

• Received
  22 Nov 2021
• Accepted
  23 Jan 2022