Obesity Paradox - The Controversial Role of Body Mass Index and Plasma Adiponectin in Coronary Artery Disease and Acute Coronary Syndrome.
Body mass index (BMI) is an anthropometric index used to evaluate a person's weight. In the general population, higher BMI is associated with more adverse outcomes as well as cardiovascular risk factors. The current clinical guidelines suggest weight control within desirable BMI as 18.5 to 24.9 kg/m(2). In the event of coronary artery disease or acute coronary syndrome, the impact of BMI on clinical outcomes still remains controversial. Some studies have demonstrated that overweight and obese patients had better prognosis than normal weight patients. Adiponectin, a secretory protein produced by adipocytes and inversely proportional to BMI, is a possible mediator for the so-called "obesity paradox", a term for the obese-protective phenomenon. Lower plasma adiponectin is associated with the progression of coronary artery disease. However, in the presence of acute coronary syndrome, patients with higher plasma adiponectin could be associated with adverse outcomes. Further studies including serial change of plasma adiponectin, or the use of other methods to discriminate lean and fat body mass are necessary to investigate this seemingly contradictory topic.


BACKGROUND
Adiponectin; Body mass index; Obesity paradox.
Division of Cardiology, Department of Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei Taiwan; ; Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei Taiwan;
Chao-Feng
CF
Lin
Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei Taiwan; ; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei Taiwan; ; Cardiovascular Research Center, National Yang-Ming University, Taipei Taiwan; ; Institute and Department of Pharmacology, National Yang-Ming University, Taipei Taiwan.
Jaw-Wen
JW
Chen