Lean mass index, body fat and survival in Chinese patients with coronary artery disease
1From the Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Wuhou District, Chengdu 610041, China.
Insights
In Chinese patients with coronary artery disease (CAD), low lean mass index (LMI) is linked to higher mortality. Higher LMI, not body fat (BF), is associated with improved survival outcomes in this population.
Area of Science:
- Cardiology
- Metabolic Health
- Clinical Research
Background:
- The 'obesity paradox' is inconsistently observed in Asian populations with coronary artery disease (CAD).
- Understanding body composition's role in CAD outcomes is crucial for this demographic.
Purpose of the Study:
- To investigate the association between body composition metrics, specifically body fat (BF) percentage and lean mass index (LMI), and clinical outcomes in Chinese patients diagnosed with CAD.
Main Methods:
- A cohort study included 3280 patients with angiographically confirmed CAD.
- Body composition was assessed using the Clínica Universidad de Navarra-Body Adiposity Estimator.
- Mortality rates were compared across quartiles of LMI.
Main Results:
- Over a median of 24 months, 288 (8.8%) deaths occurred.
- Increasing LMI showed a significant inverse association with mortality.
- Higher quartiles of LMI were independently associated with a survival benefit after multivariable adjustment (Q4 HR 0.58, Q3 HR 0.60, Q2 HR 0.60 vs. Q1 reference).
- Body fat percentage did not demonstrate a protective effect on survival in univariate analyses.
Conclusions:
- Low lean mass index (LMI) is a significant predictor of all-cause mortality in Chinese patients with coronary artery disease (CAD).
- Body fat percentage is not a significant predictor of mortality in this patient group.
Background:
'Obesity paradox' was not consistently observed in Asians with coronary artery disease (CAD).
Aim:
The study investigated the association between body composition and outcomes in Chinese patients with CAD.
Design:
Cohort study.
Method:
A total of 3280 patients with angiographically validated CAD were consecutively included. Body fat (BF) percentage and lean mass index (LMI) were evaluated using the Clínica Universidad de Navarra-Body Adiposity Estimator. The rate of mortality from any cause was compared across groups classified by the quartiles of LMI.
Results:
During a median period of 24 months, 288 (8.8%) participants died. There was a close association between increasing LMI and reducing mortality rate. However, univariate analyses did not find protective effect of BF on survival. After adjusting for age, sex, diabetes, current smoking, systolic blood pressure, creatinine, white blood cell count, haemoglobin and medication, Cox regression analyses showed that the significant relation between higher quartiles (Q) of LMI and survival benefit (Q4, hazard ratio 0.58 (95% confidence interval: 0.36-0.94) vs. Q3, 0.60 (0.39-0.91) vs. Q2, 0.60 (0.41-0.88) vs. Q1, reference) remained.
Conclusion:
Low LMI but not BF predicts all-cause mortality in Chinese patients with CAD.
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