ASSOCIATION OF OVERALL ADIPOSITY RATHER THAN BODY-MASS INDEX WITH LIPIDS AND PROCOAGULANT FACTORS

The association between obesity and risk of coronary artery disease is well established. The distribution of body fat was shown to be relate d to serum lipids and lipoproteins in a group of healthy men, but the association between body fat and haemostatic factors is less clear. Th e aim of the present study was to determine the association of overall adiposity (OVRAD, percent total fat mass contributing to body weight) and body mass index (BMI, weight/height(2)) with lipids and haemostat ic factors in order to evaluate which of these was more associated wit h circulating procoagulant factors. The total fat mass was estimated b y dual-energy X-ray absorptiometry (DEXA) and OVRAD computed for 28 ma le and 36 healthy female subjects, whose median age were 44.2 years an d 48.4 years respectively. In addition, the BMI was computed for each of them from their weight and height measurements. Fasting samples wer e analysed for serum lipids (total, HDL- and LDL-cholesterol and trigl yceride) and plasma fibrinogen, factor VII coagulant (FVII:C) activity , tissue plasminogen activator (t-PA) and plasminogen activator inhibi tor-1 (PAI-1) activities. The men and women had similar median BMI (23 .9 kg/m(2) and 23.1 kg/m(2) respectively), but the median fat mass of women (19.6 kg) was higher than that of men (16.9 kg). Age, BMI and OV RAD exhibited statistically significant correlations with lipids and h aemostatic factors in both men and women. However, when BMI was adjust ed for age and OVRAD, the statistically significant associations were no longer apparent in men or women. In contrast, OVRAD adjusted for ag e and BMI still exhibited statistically significant associations with FVII:C activity (R = 0.38, p = 0.05), triglyceride (R = 0.51, p = 0.00 8), LDL-cholesterol (R = 0.45, p = 0.02) and HDL/Total cholesterol rat io (R = -0.63, p < 0.001). It is concluded that OVRAD, a fat mass-base d index, rather than BMI, a weight-height based index, is better assoc iated with circulating coronary risk factors.