Lean mass index, body fat and survival in Chinese patients with coronary artery disease

Background India is witnessing a rising prevalence of non communicable diseases like diabetes, hypertension, coronary artery disease. This is attributed to rapid nutrition and lifestyle transition taking place since last 2 decades. Obesity is a well known independent risk factor but very little information is available about role of leanness (low BMI). We investigated whether non-obesity could be an independent risk factor for Coronary artery disease in a rural clinic in KONKAN. Methods In a cross sectional study we studied body composition of 300 patients (207 men) who underwent Coronary angiography in a rural hospital in KONKAN region. History of diabetes, hypertension and history smoking, tobacco chewing was recorded. Body composition was estimated using bio-impedance analyser. Based on results of coronary angiography, we generated a SYNTAX score derived by number of vessels involved and classified them into groups of severity of coronary artery disease (CAD). Results There were 95 (31 %) diabetes and 189 (63%) hypertensive patients in the sample and 60% of them smoked or chewed tobacco. There were 43 (28 males) patients with SYNTAX score of zero. Among those with coronary artery disease (n=257) increasing severity of CAD was associated with lower body weight, BMI, body fat percentage, and body fat mass and ejection fraction as against positive trend for lean mass and visceral fat. Conclusion BMI, fat mass decreased with severity of CAD while lean mass and visceral fat increased. We observed high proportion of CAD in underweight and lean KONKAN adults. These findings need further investigations

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Role of smoking on body fat distribution and coronary artery disease

European Heart Journal ◽

10.1093/ehjci/ehaa946.1420 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Sabet ◽

S Elkaffas ◽

S.W.G Bakhoum ◽

H Kandil

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Adipose Tissue ◽

Coronary Artery ◽

Body Fat ◽

Fat Distribution ◽

Relative Distribution ◽

Coronary Artery Atherosclerosis ◽

Total Fat ◽

Artery Disease

Abstract Introduction Smoking and obesity are recognized as important modifiable risk factors for coronary artery disease (CAD). However, the general perception that smoking protects against obesity is a common reason for starting, and/or not quitting smoking. Purpose To detect the quantity, quality and relative distribution of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated by abdominal computed tomography in smokers versus non- smokers. Methods The abdominal muscular wall was traced manually to calculate SAT and VAT areas (cm2) (outside and inside abdominal muscular wall respectively) as well as SAT density [Hounsfield units (HU)] at L4-L5 in 409 consecutive patients referred for evaluation of chest pain by multi-slice computed tomography coronary angiography (MSCT-CA). Results 26% of the studied patients (n=107) were current smokers, while the remaining 74% (n=302) never smoked. Coronary artery atherosclerosis was more prevalent in smokers compared to non-smokers (64.5% vs 55.0%; p=0.09). Smokers had statistically significantly lower body mass index (BMI) (31.2±4.3 vs. 32.5±4.7 kg/m2; p=0.015), hip circumference (HC) (98.6±22.5 vs. 103.9±20.9 cm; p=0.031), total fat area (441.62±166.34 vs. 517.95±169.51cm2; p<0.001), and SAT area (313.07±125.54 vs. 390.93±143.28 cm2; p<0.001) as compared to non-smokers. However, smokers had statistically significantly greater waist-to-hip ratio (0.98±0.08 vs. 0.96±0.08; p=0.010), VAT/SAT area ratio (0.41±0.23 vs. 0.35±0.20; p=0.013), and denser SAT depot (−98.91±7.71 vs. −102.08±6.44 HU; p<0.001). Conclusion Smoking contributes to CAD and to the pathogenic redistribution of body fat towards VAT, through limiting SAT potential to expand. Funding Acknowledgement Type of funding source: None

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