Gender Differences in the Relationship of Waist Circumference to Coronary Artery Lesions and One-Year Re-Admission Among Coronary Artery Disease Patients with Normal Body Mass Index

Hui Luan; Yan Song; Lifei Cao; Ping Wang; Danjun Zhu; Gang Tian

doi:10.2147/DMSO.S330194

Gender Differences in the Relationship of Waist Circumference to Coronary Artery Lesions and One-Year Re-Admission Among Coronary Artery Disease Patients with Normal Body Mass Index

Diabetes Metab Syndr Obes. 2021 Sep 23:14:4097-4107. doi: 10.2147/DMSO.S330194. eCollection 2021.

Authors

Hui Luan¹, Yan Song², Lifei Cao¹, Ping Wang¹, Danjun Zhu¹, Gang Tian¹

Affiliations

¹ Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaanxi Province, People's Republic of China.
² Department of Ultrasound, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shaanxi Province, People's Republic of China.

Abstract

Purpose: The study explored the association of waist circumference (WC) with the severity of cardiovascular diseases and hospital readmission of coronary artery disease (CAD) patients with normal body mass index (BMI).

Patients and methods: 213 female and 431 male normal-BMI CAD patients were enrolled and assigned in three groups based on their gender-specific WC tertiles. Their cardiovascular risk factors and coronary angiography characteristics were analyzed in a cross-sectional study, and the gender-specific relationship between WC and one-year re-admission rate was prospectively explored.

Results: The cross-sectional analysis showed that for male normal-BMI CAD patients, diabetes and dyslipidemia prevalence, Apo B/A1, hs-CRP, and uric acid levels triglycerides-glucose index, the incidence of left main disease, three vessel disease, calcification lesion, total occlusive lesion, and complex lesion, as well as Gensini score was in the order of WC tertile 3 > WC tertile 2 > WC tertile 1. In addition, male normal-BMI CAD patients in the highest WC tertile were at an increased risk of severe CAD (OR=2.21), and the correlation was still statistically significant even after adjusting for potential cardiovascular risk factors (OR=1.87). For female normal-BMI CAD patients, as the WC tertiles increased, uric acid level, the prevalence of three vessel disease, diffuse lesion, and complex lesion gradually increased (P <0.05), but no significant difference was found in the risk of severe CAD among different WC groups (all P >0.05). Prospective analyses showed that the higher the WC tertile was, the higher the one-year re-admission rate in men, but not in women, and after adjusting for other risk factors, men with the highest WC tertile showed more than twice the risk of patients with the lowest WC tertile.

Conclusion: Male but not female, normal-BMI CAD patients with increased WC had more severe CAD and a higher risk of one-year re-admission rate.

Keywords: coronary artery disease; normal body mass index; one-year re-admission with adverse cardiovascular event; severe CAD; waist circumference.

Grants and funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Nature Science Foundation of China (Grant Nos. 81873513, 81600574, and 30871042), Key Projects of Shaanxi Science and Technology Research and Development Plan (Grant No. 2018ZDXM-SF-049), Key Project of Clinical Research in the First Affiliated Hospital of Xi’an Jiao tong University (Grant No. XJTU1AF-CRF-2018-005) and Shaanxi Science and Technology Research and Development Plan of International Science and Technology (Grant No. 2012 kw-40-01 and 2014 JM2-8145).