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Coronary atherosclerosis in relation to body fatness and its distribution
J M Hodgson1, M L Wahlqvist, N D Balazs
1Monash University Department of Medicine, Clayton, Victoria, Australia.
Insights
Abdominal fat distribution, measured by waist-to-hip ratio, showed a slight association with coronary artery disease (CAD) severity in men and women. However, this link weakened after accounting for other coronary heart disease risk factors.
Area of Science:
- Cardiology
- Public Health
- Medical Research
Background:
- Coronary artery disease (CAD) remains a leading cause of mortality worldwide.
- Body fat distribution, particularly abdominal adiposity, is increasingly recognized as a significant risk factor for cardiovascular diseases.
- Understanding the interplay between body composition and CAD severity is crucial for effective prevention and treatment strategies.
Purpose of the Study:
- To investigate the relationship between total body fatness and abdominal fat distribution with angiographically assessed coronary artery disease (CAD).
- To evaluate the utility of body mass index (BMI) and waist-to-hip ratio (WHR) as indicators of CAD severity.
- To explore potential confounding factors influencing the association between body fat metrics and CAD.
Main Methods:
- A cross-sectional study involving 226 patients undergoing coronary angiography.
- Quantification of CAD using an 'extent score' and a 'myocardial score'.
- Assessment of total body fatness via BMI and abdominal fat distribution via WHR, derived from self-reported measurements.
Main Results:
- BMI was not significantly associated with either CAD scoring system.
- WHR showed a positive association with both extent and myocardial scores (P < 0.05) in the combined male and female cohort.
- A positive association was observed between WHR and the myocardial score in women aged 40-70 (P < 0.05), but these associations were not significant after adjusting for other coronary heart disease risk factors.
Conclusions:
- While WHR demonstrated a preliminary association with CAD severity, this relationship appears to be mediated by other established coronary heart disease risk factors.
- BMI is not a reliable indicator of CAD severity in this patient cohort.
- Further research is warranted to elucidate the complex interplay of various risk factors in the development and progression of CAD.
Abstract:
In a cross-sectional study of 226 patients (160 men and 66 women) who underwent coronary angiography, the relationships between total body fatness and abdominal fat distribution, and angiographically assessed coronary artery disease (CAD) were examined. Two different scoring systems were used to quantify the degree of CAD: an 'extent score' and a 'myocardial score'. The extent score provides an estimate of the extent of coronary atherosclerosis and the myocardial score provides an assessment of the amount of myocardium threatened by coronary lesions. Total body fatness was estimated using the body mass index (BMI) and the waist-to-hip circumference ratio (WHR) was used to assess abdominal fat distribution. The weight and height were obtained by questionnaire at the time of angiography, and self-reported waist and hip circumference measurements were used to calculate WHR. The BMI and WHR were associated with several coronary heart disease (CHD) risk factors. However, BMI was not significantly associated with either of the CAD scores. The WHR was positively associated with both the extent score (rs = 0.18; P < 0.05) and the myocardial score (rs = 0.17; P < 0.05) for men and women together, and positively associated with the myocardial score for women aged 40 to 70 years (rs = 0.32; P < 0.05). The associations between WHR and the CAD scores were not significant after adjusting for several risk factors for CHD. These results indicate that other risk factors for CHD may be involved in the associations between WHR and CAD.