Which method should be used to determine the obesity, in patients with coronary artery disease?: (body mass index, waist circumference or waist-hip ratio)

OBJECTIVE: To determine body mass index (BMI), waist circumference and waist-hip ratio (WHR) in cases with angiographically established coronary artery disease (CAD) and to compare the obesity degrees established according to the ranges determined by the International Guidelines Committees for BMI, waist circumference and WHR. DESIGN: Cross-sectional, observational study. SUBJECTS: A total of 617 consecutive cases (516 males, mean age: 57.2 +/- 10.8y) with CAD who underwent their first coronary angiography between January 2000 and May 2000. MEASUREMENTS: Before coronary angiography, their heights, weights, waist and hip circumferences were measured. Waist circumferences, BMI and WHRs were compared both as a whole and also within stratified groups as for sexes and age groups categorized in decades above 40y of age. RESULTS: Overweight cases comprised approximately half of the patients in both sexes. In males, the percentages of obese cases with respect to BMIs were 15%, while males with action level 2 waist circumferences were detected to be 20%. Obese male patients whose WHRs were greater than or equal to0.95 were found to be 51%. In female cases, corresponding percentages of obesity were estimated to be 32, 72 and 86%, respectively. CONCLUSION: In the same patient groups, the prevalence of obesity, defined by BMI, waist circumference and WHR, could vary three-fold. Thus, some patients may not display a diagnosis of obesity. To prevent this possibility the waist circumference is an easy method, which reflects central obesity more accurately.