title: Is the relationship of body mass index to severity of coronary artery disease different from that of waist-to-hip ratio and severity of coronary artery disease? Paradoxical findings.
abstract: BACKGROUND
  Although for decades there has been controversy regarding the relationship between obesity and coronary artery disease (CAD), it has been assumed that high body mass index (BMI) is a risk factor for CAD. However, the findings of some recent studies were paradoxical.
  
  
  OBJECTIVE
  The aim of this study was to find a relationship between high BMI and waist-to-hip ratio (WHR) with severity of CAD.
  
  
  METHODS
  This study was a cross-sectional, prospective study where 414 patients with suspected coronary artery disease, in whom coronary angiography was performed, were enrolled. The mean ± SD of their ages was 61.2 ± 27.4 years (range 25-84), and 250 (60.4%) were male. Regarding cardiovascular risk factors, 113 (27.3%) patients had a history of diabetes mellitus (DM), 162 (39.1%) had hypercholesterolaemia, 238 (57.4%) had hypertension, 109 (26.3%) were current smokers and 24 (5.8%) had a family history of CAD. The mean ± SD of the patients' BMI was 26.04 ± 4.08 kg/m(2) (range 16-39) and means ± SD of their WHR ranged from 0.951 ± 0.07 to 0.987 ± 0.05. The mean ± SD of the severity of CAD according to the SYNTAX and Duke scores were 17.7 ± 9.6 (range 0-64) and 3.2 ± 1.7 (range 0-12), respectively.
  
  
  RESULTS
  In this study, findings showed a negative correlation between the severity of CAD and BMI, according to both SYNTAX and Duke scores (p ≤ 0.001 and p = 0.001, respectively). However, there was a positive correlation between WHR and severity of CAD, according to the Duke score (p = 0.03).
  
  
  CONCLUSIONS
  BMI had a negative correlation with the severity of CAD, but waist-to-hip ratio had a positive correlation with severity of CAD.
authors.affiliation: Division of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. zandparsa@tums.ac.ir.
authors.forename: A F
authors.initials: AF
authors.lastname: Parsa
authors.affiliation: Division of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: B
authors.initials: B
authors.lastname: Jahanshahi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D012720:Severity of Illness Index; D049629:Waist-Hip Ratio; D055815:Young Adult