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Central adipose distribution is related to coronary atherosclerosis
C J Thompson1, J E Ryu, T E Craven
1Department of Epidemiology, University of North Carolina, Chapel Hill 27599.
Insights
Abdominal obesity, indicated by a high waist/hip ratio, is linked to coronary atherosclerosis in both women and men. This finding helps explain increased cardiovascular disease risk associated with this fat distribution pattern.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- A "male" adipose tissue distribution (central obesity) in women is associated with symptomatic cardiovascular disease.
- Elevated waist/hip ratio is linked to cardiovascular, cerebrovascular diseases, and metabolic risk factors in men.
Purpose of the Study:
- To investigate the relationship between adipose tissue distribution and coronary atherosclerosis.
Main Methods:
- A case-control study was conducted.
- Cases had angiographically documented coronary atherosclerosis.
- Controls included angiographically normal hospital and neighborhood individuals.
Main Results:
- Waist/hip ratio was significantly higher in female cases versus controls.
- Males with coronary atherosclerosis had a higher waist/hip ratio than asymptomatic neighborhood controls.
- Results remained significant after adjusting for age, lipids, BMI, hypertension, diabetes, and smoking.
Conclusions:
- Adipose tissue distribution, assessed by waist/hip ratio, is significantly associated with coronary atherosclerosis in both sexes.
- Central obesity may partly explain the increased cardiovascular disease risk in women with this fat distribution.
- Men with abdominal fat deposition also face elevated risks.
Abstract:
A "male" distribution of adipose tissue in women (excess of fat in the abdomen compared with that in the hips; i.e., elevated waist/hip ratio) has been related to symptomatic cardiovascular disease. An elevated waist/hip ratio has also been related to symptomatic cardiovascular and cerebrovascular diseases in men, as well as to risk factors for these diseases and various metabolic conditions. To determine whether adipose distribution was related to coronary atherosclerosis, we performed a case-control study in patients with angiographically documented coronary atherosclerosis (cases) and in angiographically normal hospital and neighborhood controls. The data show that distribution of adiposity as assessed by waist/hip ratio is significantly related to coronary atherosclerosis in both females and males. Waist/hip ratio is significantly greater in female cases compared with either control group; in males, waist/hip ratio is significantly greater in cases compared with asymptomatic neighborhood controls but not compared with patients with normal coronary arteries. These results persist after control for age, plasma concentrations of lipids and lipoproteins, body mass index, history of hypertension, history of diabetes, and smoking status. The connection between the male adipose distribution in females and coronary atherosclerosis partly explains the greater likelihood of symptomatic cardiovascular disease in them. Males with excess deposition of fat in the abdominal region are also likely to experience increased risk.