Coronary risk profiles in men with coronary artery disease: effects of body composition, fat distribution, age and fitness

Background Few studies have investigated the influence of body composition, abdominal obesity, age and fitness on coronary risk factors in populations of patients with coronary heart disease (CHD). We investigated whether abd ominal obesity or generalized adiposity is a better predictor of cardiovasc ular risk in men with coronary artery disease (CAD), and the effects of exe rcise training on coronary risk factors in younger and older patients with CAD. Methods The study population consisted of 81 male patients aged 33-83 years (mean +/- SD 60.0 +/- 13.3 years) with established CAD. We studied the rel ationships among body composition, body fat distribution, dietary intake, p eak aerobic capacity, lipid concentrations, and plasma glucose and insulin concentrations. We subsequently measured the influence of exercise training on these components. Results The study population was characterized by a high prevalence of obes ity, particularly in younger patients. Body mass index, rather than body fa t distribution, was the best anthropometric predictor of plasma triglycerid e concentrations (r(2) = 0.1 1, P < 0.05) and cholesterol/high-density lipo protein cholesterol (HDL-C) ratio (r(2) = 0.13, P < 0.01), Body weight, rat her than body fat distribution, was the best predictor of plasma HDL-C conc entration (r(2) = 0.14, P < 0.01) and fasting glucose concentrations (r(2) = 0.10, P < 0.06). Fat mass was the best anthropometric predictor of fastin g plasma insulin concentrations (r(2) = 0.38, P < 0.0001) and for the gluco se-insulin ratio (r(2) = 0.39, P < 0.0001) in men with CAD. Younger patient s tended to have greater improvements in HDL-C concentrations and the chole sterol:HDL-C ratio than did older individuals, as a result of exercise trai ning. Conclusion In men with CAD, general measures of obesity, such as body weigh t, body mass index, and fat mass are better predictors of coronary risk fac tors than body fat distribution. Younger and older men with CAD experienced similar improvements in body composition and body fat distribution after a n exercise training program. Coronary Artery Dis 1 1 :137-144 (C) 2000 Lipp incott Williams & Wilkins.