Background: The association with high-carbohydrate diet with increased level of triglycerides and decreased level of high-density lipoprotein cholesterol (HDL-C) is well known. But the direct effect of macronutrient ratio on the coronary atherosclerosis is not evaluated. We analyzed the correlation of high-carbohydrate diet and coronary artery calcium scoring (CACS), and serum lipoprotein profiles and high-sensitivity C-reactive protein (hs-CRP) levels. Methods: In total 496 women who have taken health screening exam in Seoul National University Hospital Healthcare system Gangnam Center from 1, Jan 2003 to 31, Dec 2009 were included in the analysis. One-day recall dietary records were taken by experienced interviewers. CACSs, fasting serum lipoprotein profiles and hs-CRP levels were evaluated. Correlation analysis was performed to reveal the association between high-carbohydrate diet and CACSs, serum lipoprotein profiles and hs-CRP levels. Results: CACS was not associated with proportions of carbohydrate or total fat in total energy intakes. HDL-C level was negatively associated with CACS (r = -0.105, p = 0.019). HDL-C level itself was inversely associated with proportion of carbohydrate in total energy intakes (r = -0.195, p = 0.001) and associated with proportion of total fat in total energy intakes (r = 0.199, p = 0.001). Conclusion: Proportions of carbohydrate or total fat in total energy intakes were not associated with CACS. Only HDL-C level was negatively associated with CACS.