RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
32
VOLUME 14 NUMBER 1 • JULY 2017
Moreover, according to the studies of Morricone, Empana and
Zhang, which were published in 1999, 2004 and 2008, respectively,
abdominal adiposity and severity of CAD were correlated.
12-14
Although their findings were similar to ours regarding correlation
between WHR/abdominal obesity and severity of CAD, they did not
compare BMI with WHR regarding their impact on the severity of
CAD, as we did. These studies showed that, first, high BMI per se was
not a risk factor for CAD, and second, high WHR/abdominal obesity
was a risk factor for CAD. That means abdominal fat accumulation
is more pathological (adiposopathic) than subcutaneous fat
accumulation.
19,24
Although in our study, regression analysis for confounding
factors such as DM, HTN, cigarette smoking and hyperlipidaemia
revealed a statistically significant correlation between them and the
severity of CAD (
p
= 0.002,
p
= 0.001,
p
= 0.04 and
p
= 0.02,
respectively), after omission of confounding factors, there was
still a paradoxical relationship between BMI and severity of CAD.
β
-coefficients before multivariate analysis were –0.2 and –0.18,
and after multivariate analysis they were –0.17 and –0.14, based on
the SYNTAX and Duke scores, respectively. This showed an inverse
relationship between BMI and severity of CAD.
The limitation of our study was that lower BMI (20–24 kg/m
2
)
was more prevalent (56.2%) in the older age groups (> 60 years),
and higher BMI (30–34 kg/m
2
) was more common (57.8%) in the
younger age groups (40–59 years). As in the study by Niraj
et al
.,
11
it can be concluded that patents with a higher BMI have been
evaluated earlier for CAD. This indicates a need for a larger study
with more age-matched groups.
Conclusion
The findings of this study, paradoxically, showed a negative
correlation between BMI and the severity of CAD, but a positive
correlation between WHR and the severity of CAD.
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