High body mass index is not associated with coronary artery disease in angina patients with chronic kidney disease: a coronary angiography study.
BACKGROUND
High body mass index (BMI) is an established risk factor for coronary artery disease (CAD) in the general population. This relationship is less clear in CAD patients with different stages of chronic kidney disease (CKD) because many complications of CKD can cause malnutrition and low BMI. We studied the association of BMI and angiography-confirmed CAD in CKD patients.


METHODS
Thousand one hundred thirty-three patients admitted for coronary angiography was stratified by CKD classification. Demographic, clinical, hemodynamic, and angiographic findings were assessed. CKD patients (n = 980) were divided into angiographic CAD and non-CAD groups to compare traditional CAD risk factors. Patients with angiography-confirmed CAD (n = 496) were further analyzed for the association between BMI and CAD risk at different stages of CKD patients.


RESULTS
Mean BMI was 27.4 +/- 4.1, 27.7 +/- 4.0, 25.9 +/- 3.5, 24.2 +/- 3.8, 23.2 +/- 3.0 and 23.8 +/- 4.2 kg/m for normal renal function, stage I, II, III, IV, and V CKD patients, respectively. Male, old age, presence of CKD, diabetes, hypertension, smoking, and higher cholesterol had significant association with angiographic CAD in the CKD sub-cohort. Obesity was not related to CAD in the CKD sub-cohort. Using WHO category for obesity, mild CKD patients were more likely to be overweight (62.8%) and obese (72%); meanwhile, most moderate and severe CKD patients were not obese (P < 0.05). Only 17.6% and 18.8% of moderate and severe CKD patients were obese (P < 0.05), by Taiwan classification.


CONCLUSIONS
High BMI was not associated with angiographic CAD in CKD patients with angina.
Wu
I-Wen
IW
Department of Nephrology, Keelung Chang Gung Memorial Hospital, Taipei, Taiwan.
Hung
Ming-Jui
MJ
Chen
Yung-Chang
YC
Cherng
Wen-Jin
WJ
Wu
Mai-Szu
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000150:complications*; D015992:Body Mass Index; D002908:Chronic Disease; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology