Obesity, body fat distribution and coronary atherosclerosis among Japanesemen and women

OBJECTIVE: To investigate the relation of the obesity and body-fat distribu tion with angiographically defined coronary atherosclerosis. DESIGN: Cross-sectional study in a clinical setting. SUBJECTS: Three hundred and twenty men (median age, 59 y) and 212 women (me dian age, 67 y) who underwent coronary angiography for suspected or known c oronary heart disease at 5 cardiology departments between September 1996 an d August 1997. Patients with disease duration > 1 y were excluded. MEASUREMENTS: The body mass index (BMI) and the waist to hip circumference ratio (WHR) were used as main exposure variables, and either the presence o f significant coronary stenosis or the Gensini's score (greater than or equ al to 10 vs < 10) as an outcome variable, in a sex-specific multiple logist ic regression analysis controlling for age, hospital, and other coronary ri sk factors. RESULTS: Among male patients, BMI was progressively higher with an increasi ng number of vessels involved (P trend = 0.05); the adjusted odds ratios fo r the presence of significant stenosis across quartiles of BMI were 1.0 (re ference), 1.1, 1.9 and 2.5 (P trend = 0.02), and the positive association w as more pronounced for younger patients. Among females, however, such assoc iations were not evident. Employing the Gensini's score as an outcome gave similar results. WHR was not significantly associated with either outcome r egardless of sex. CONCLUSION: These results suggested that BMI was predictive of coronary ste nosis among male patients, but not among female patients. Unlike most previ ous studies, this study failed to detect a positive association with WHR.