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Association between anthropometric obesity measures and coronary artery disease - a cross-sectional survey of 16,657 subjects from 444 Polish cities
  1. Bernhard M Kaess (bernhard_kaess{at}gmx.de)
  1. University of Regensburg, Germany
    1. Jacek Jozwiak
    1. Medical University of Silesia, Zabrze, Poland
      1. Miroslaw Mastej
      1. Silesian Analytical Laboratories, Katowice, Poland
        1. Witold Lukas
        1. Medical University of Silesia, Zabrze, Poland
          1. Wladyslaw Grzeszczak
          1. Medical University of Silesia, Zabrze, Poland
            1. Adam Windak
            1. Medical College Jagiellonian University, Krakow, Poland
              1. Wieslawa Piwowarska
              1. Medical College Jagiellonian University, Krakow, Poland
                1. Andrze Tykarski
                1. University of Medical Sciences, Poznan, Poland
                  1. Ewa Konduracka
                  1. Medical College Jagiellonian University, Krakow, Poland
                    1. Katarzyna Rygiel
                    1. Medical University of Silesia, Zabrze, Poland
                      1. Ahmed Manasar
                      1. Silesian Analytical Laboratories, Katowice, Poland
                        1. Nilesh J Samani
                        1. University of Leicester, United Kingdom
                          1. Maciej Tomaszewski (mt142{at}le.ac.uk)
                          1. University of Leicester, United Kingdom

                            Abstract

                            Excessive body weight is known to cluster with cardiovascular (CV) risk factors, but it is not clear which anthropometric obesity measure provides best independent predictive value of coronary artery disease (CAD).

                            Methods and results: We explored associations between CAD and 4 different obesity measures (body mass index [BMI], waist circumference, waist/height and waist/height2) in a cohort of 16,657 subjects (40.4% men; 20.8% CAD patients), recruited by 700 primary care physicians in 444 Polish cities. 42.8% of subjects were classified as overweight, 31.7% as obese and 39.8% had abdominal obesity. In univariate analyses all obesity measures correlated with CAD (p>0.001), but waist/height2 was the strongest discriminator between CAD patients and controls. Age- and sex-adjusted analyses confirmed a graded increase in CAD risk across distributions of all 4 obesity measures - one standard deviation increase in BMI, waist, waist/height and waist/height2 increased the odds of CAD by 1.23, 1.24, 1.26 1.27, respectively (all p<0.001). In models fully adjusted for CV risk factors, waist/height2 remained the strongest obesity correlate of CAD, being the only independent associate of CAD in men. In a fully adjusted BMI – waist circumference stratified model, sarcopenic obesity (waist > median, BMI < median) and simple obesity (waist and BMI > median) were the strongest independent associates of CAD in men (p=0.008) and women (p>0.001), respectively.

                            Conclusion: This cross-sectional study showed that waist/height2; may potentially offer a slightly higher predictive value of CAD than BMI or waist circumference and revealed an apparent sexual dimorphism in correlations between obesity measures and CAD .

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