Vol. 43 | No. 1 | January-June 2015 Back

Open Access

Comparison of Body Mass Index, Waist-to-hip Ratio and Waist-to- height Ratio as Predictor of the Severity of Coronary Artery Disease Based on Gensini Scoring System on Coronary Angiography

Kathy Lou B. Tomandao, Edwin K. Tiempo
Jun 2015 DOI 10.69944/pjc.b77f647110

Abstract

OBJECTIVE: This study aimed to determine the correlation of body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) with the severity of coronary artery disease (CAD) based on the Gensini scoring system on coronary angiography among Filipinos. 

METHODOLOGY: This was a cross-sectional, analytical study conducted at Perpetual Succour Hospital–Cebu Heart Institute. It included all admitted Filipino patients who were suspected to have CAD with indications to undergo coronary angiography from March 1, 2014 to September 30, 2014. 

RESULTS: A total of 101 patients were included in the study. The mean BMI was 26.83 kg/m2, with most patients (45.5%) having normal BMI. Forty percent were overweight, 7.9% were obese and 6% were very obese. The mean WHR was 0.98 and 97% of patients had a high ratio. The mean WHtR was 0.59 and 96% had a high ratio. Fifty-six percent had significant CAD. The mean Gensini Score was 41.14 and 50.5% of patients had a score of >20. BMI showed no correlation with the severity of CAD by Gensini score (p=0.355). There was a trend towards a weak positive correlation between WHR and Gensini score (r=0.194; p=0.052). WHtR did not show a significant relationship with severity of CAD based on Gensini score (p=0.801). 

CONCLUSION: BMI, WHR and WHtR did not show significant correlations with the presence of significant CAD. However, there was a trend towards a weak positive correlation between WHR and CAD severity by Gensini score; hence, it may still be useful as a predictor for CAD severity among Filipinos. 

KEYWORDS: Anthropometric indices, body mass index, waist-to-hip ratio, waist-to-height ratio, coronary artery disease, Gensini score. 

References
  1. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2985-3023. 
  2. Food and Nutrition Research Institute. 8th National Nutrition and Health Survey. Available at: www.fnri.dost.gov.ph. 
  3. Patil VC, Parale GP, Kulkarni PM, Patil HV. Relation of anthropometric variables to coronary artery disease risk factors. Indian J Endocrinol Metab. 2011 Jan;15(1):31-7. 
  4. Nishida C, Ko GT, Kumanyika S. Body fat distribution and noncommunicable diseases in populations: overview of the 2008 WHO Expert Consultation on Waist Circumference and Waist-Hip Ratio. Eur J Clin Nutr. 2010 Jan;64(1):2-5. 
  5. Kaess BM, Jozwiak J, Mastej M, Association between anthropometric obesity measures and coronary artery disease: a cross-sectional survey of 16,657 subjects from 444 Polish cities. Heart. 2010 Jan;96(2):131- 5. 
  6. Ashwell M, Gunn P, Gibson S. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis. Obes Rev. 2012 Mar;13(3):275-86. 
  7. Browning LM, Hsieh SD, Ashwell M. A systematic review of waist to height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutr Res Rev. 2010;23:247–269. 
  8. Zeller M, Steg PG, Ravisy J, et al. Relation between body mass index, waist circumference, and death after acute myocardial infarction. Circulation. 2008;118:482-490. 
  9. Acuin C, Duante C. Waist circumference (WC) & Waist:Hip Ratio (WHR) predict hypertension and diabetes risk better than Body Mass Index (BMI) among Filipinos. FASEB J. 2013;27:1055.19. 
  10. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983;51:606.
  11.  Labounty TM, Gomez MJ, Achenbach S, et al. Body mass index and the prevalence, severity, and risk of coronary artery disease: an international multicentre study of 13,874 patients. Eur Heart J Cardiovasc Imaging. 2013 May;14(5):456-63. 
  12. Obesity: Preventing and managing the Global Epidemic - Report of a WHO Consultation on Obesity, 3-5 June 1997, Geneva, WHO/ NUT/NCD/98.1 
  13. Chagas P, Caramori P, Barcellos C, et al. Association of different anthropometric measures and indices with coronary atherosclerotic burden. Arq Bras Cardiol. 2011 Nov;97(5):397-401.
License

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.