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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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