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A Little Belly Fat can double the Risk of
Death in Coronary Artery Disease Patients
Newswise, May 5, 2011 —One of the largest
studies of its kind has found that people
with coronary artery disease who have even a
modest beer belly or muffin top are at
higher risk for death than people whose fat
collects elsewhere.
The effect was observed even in patients
with a normal Body Mass Index (BMI). The
findings of this Mayo Clinic analysis are
published in the May 10 issue of theJournal
of the American College of Cardiology.
Researchers analyzed data from 15,923 people
with coronary artery disease involved in
five studies from around the world. They
found that those with coronary artery
disease and central obesity, measured by
waist circumference and waist-to-hip ratio,
have up to twice the risk of dying. That is
equivalent to the risk of smoking a pack of
cigarettes per day or having very high
cholesterol, particularly for men.
The findings refute the obesity paradox, a
puzzling finding in many studies that shows
that patients with a higher BMI and chronic
diseases such as coronary artery disease
have better survival odds than normal-weight
individuals.
“We suspected that the obesity paradox was
happening because BMI is not a good measure
of body fatness and gives no insight into
the distribution of fat,” says Thais
Coutinho, M.D., the study’s lead author and
a cardiology fellow at Mayo Clinic.
“BMI is just a measure of weight in
proportion to height. What seems to be more
important is how the fat is distributed on
the body,’’ she says.
Francisco Lopez-Jimenez, M.D., the project’s
lead investigator and director of the
Cardiometabolic Program at Mayo Clinic,
explains why this type of fat may be more
harmful: “Visceral fat has been found to be
more metabolically active. It produces more
changes in cholesterol, blood pressure and
blood sugar. However, people who have fat
mostly in other locations in the body,
specifically, the legs and buttocks, don’t
show this increased risk.”
The researchers say physicians should
counsel coronary artery disease patients who
have normal BMIs to lose weight if they have
a large waist circumference or a high
waist-to-hip ratio. The measure is very easy
to use, Dr. Coutinho says: “All it takes is
a tape measure and one minute of a
physician’s time to measure the perimeter of
a patient’s waist and hip.”
The research subjects were diverse, coming
from studies in the U.S. (Rochester, Minn.
and San Francisco, Calif.), Denmark, France
and Korea. The inclusion of different ethnic
groups makes the study more applicable to
the real world, Dr. Coutinho says.
Other members of the research team are
Kashish Goel, M.D.; Daniel Correa de Sa,
M.D.; Randal Thomas, M.D.; Veronique Roger,
M.D., MPH; and Virend Somers, M.D., Ph.D.,
of Mayo Clinic; Charlotte Kragelund, M.D.,
Ph.D.; Lars Kober, M.D., Ph.D.; and
Christian Torp-Pedersen, M.D., Ph.D., from
Rigshaspitalet, Copenhagen, Denmark; Alka
Kanaya, M.D. of the University of
California, San Francisco, California;
Jong-Seon Park, M.D.; Sang-Hee Lee, M.D.;
and Young-Jo Kim, M.D., of Yeungnam
University Hospital, Daegu, Korea; and Yves
Cottin, M.D., Ph.D.; and Luc Lorgis, M.D.,
from CHU Bocage, Dijon, France.
About Mayo Clinic
Mayo Clinic is a nonprofit worldwide leader
in medical care, research and education for
people from all walks of life. For more
information, visit www.mayoclinic.org/about/ andwww.mayoclinic.org/news.
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