Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Paper
  • Published:

Obesity, body fat distribution and coronary atherosclerosis among Japanese men and women

International Journal of Obesity volume 25, pages 191–197 (2001)Cite this article

Abstract

OBJECTIVE: To investigate the relation of the obesity and body-fat distribution with angiographically defined coronary atherosclerosis.

DESIGN: Cross-sectional study in a clinical setting.

SUBJECTS: Three hundred and twenty men (median age, 59 y) and 212 women (median age, 67 y) who underwent coronary angiography for suspected or known coronary heart disease at 5 cardiology departments between September 1996 and August 1997. Patients with disease duration >1 y were excluded.

MEASUREMENTS: The body mass index (BMI) and the waist to hip circumference ratio (WHR) were used as main exposure variables, and either the presence of significant coronary stenosis or the Gensini's score (≥10 vs<10) as an outcome variable, in a sex-specific multiple logistic regression analysis controlling for age, hospital, and other coronary risk factors.

RESULTS: Among male patients, BMI was progressively higher with an increasing number of vessels involved (P trend=0.05); the adjusted odds ratios for the presence of significant stenosis across quartiles of BMI were 1.0 (reference), 1.1, 1.9 and 2.5 (P trend=0.02), and the positive association was more pronounced for younger patients. Among females, however, such associations were not evident. Employing the Gensini's score as an outcome gave similar results. WHR was not significantly associated with either outcome regardless of sex.

CONCLUSION: These results suggested that BMI was predictive of coronary stenosis among male patients, but not among female patients. Unlike most previous studies, this study failed to detect a positive association with WHR.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Hubert HB, Feinleib M, McNamara PM, Castelli WP . Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study Circulation 1983 67: 968–977.

    Article  CAS  PubMed  Google Scholar 

  2. Manson JE, Colditz GA, Stampfer MJ, Willett WC, Rosner B, Monson RR, Speizer FE, Hennekens CH . A prospective study of obesity and risk of coronary heart disease in women New Engl J Med 1990 322: 882–889.

    Article  CAS  PubMed  Google Scholar 

  3. Willett WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH . Weight, change, and coronary heart disease in women. Risk within the ‘normal’ weight range JAMA 1995 273: 461–465.

    Article  CAS  PubMed  Google Scholar 

  4. Pearson TA . Coronary arteriography in the study of the epidemiology of coronary artery disease Epidemiol Rev 1984 6: 140–166.

    Article  CAS  PubMed  Google Scholar 

  5. Hodgson JM, Wahlqvist ML, Balazs ND, Boxall JA . Coronary atherosclersis in relation to body fatness and its distribution Int J Obes Relat Metab Disord 1994 18: 41–46.

    CAS  PubMed  Google Scholar 

  6. Reed D, Yano K . Predictors of arteriographically defined coronary stenosis in the Honolulu Heart Program. Comparisons of cohort and arteriography series analyses Am J Epidemiol 1991 134: 111–122.

    Article  CAS  PubMed  Google Scholar 

  7. Larsson B, Svardsudd K, Welin L, Wilhelmsen L, Bjorntorp P, Tibblin G . Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913 Br Med J 1984 288: 1401–1404.

    Article  CAS  Google Scholar 

  8. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L . Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden Br Med J 1984 289: 1257–1261.

    Article  CAS  Google Scholar 

  9. Hartz A, Grubb B, Wild R, Van Nort JJ, Kuhn E, Freedman D, Rimm A . The association of waist hip ratio and angiographically determined coronary artery disease Int J Obes 1990 14: 657–665.

    CAS  PubMed  Google Scholar 

  10. Hauner H, Stangl K, Schmatz C, Burger K, Blomer H, Pfeiffer EF . Body fat distribution in men with angiographically confirmed coronary artery disease Atherosclerosis 1990 85: 203–210.

    Article  CAS  PubMed  Google Scholar 

  11. Nakamura T, Tokunaga K, Shimomura I, Nishida M, Yoshida S, Kotani K, Islam AH, Keno Y, Kobatake T, Nagai Y, Fujioka S, Tarui S, Matsuzawa Y . Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men Atherosclerosis 1994 107: 239–246.

    Article  CAS  PubMed  Google Scholar 

  12. World Health Organization . World Health Statistics Annual 1995 WHO: Geneva 1996.

    Google Scholar 

  13. Austen WG, Edwards JE, Frye RL, Gensini GG, Gott VL, Griffith LS, McGoon DC, Murphy ML, Roe BB . A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association Circulation 1975 51 (Suppl 4): 5s–40s.

    Article  Google Scholar 

  14. Gensini GG . A more meaningful scoring system for determining the severity of coronary heart disease Am J Cardiol 1983 51: 606.

    Article  CAS  PubMed  Google Scholar 

  15. Rothman KJ . Modern Epidemiology Little Brown and Company: Boston 1986.

    Google Scholar 

  16. Terry RB, Page WF, Haskell WL . Waist/hip ratio, body mass index and premature cardiovascular disease mortality in US Army veterans during a twenty-three year follow-up study Int J Obes Relat Metab Disord 1992 16: 417–423.

    Google Scholar 

  17. Lee IM, Manson JE, Hennekens CH, Paffenbarger RS Jr . Body weight and mortality. A 27-year follow-up of middle-aged men JAMA 1993 270: 2823–2828.

    Article  CAS  PubMed  Google Scholar 

  18. Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE, Hennekens CH, Speizer FE . Body weight and mortality among women New Engl J Med 1995 333: 677–685.

    Article  CAS  PubMed  Google Scholar 

  19. Stevens J, Cai J, Pamuk ER, Williamson DF, Thun MJ, Wood JL . The effect of age on the association between body-mass index and mortality New Engl J Med 1998 338: 1–7.

    Article  CAS  PubMed  Google Scholar 

  20. Barrett-Connor EL . Obesity, atherosclerosis, and coronary artery disease Ann Intern Med 1985 103: 1010–1019.

    Article  CAS  PubMed  Google Scholar 

  21. Keys A, Menotti A, Aravanis C, Blackburn H, Djordevic BS, Buzina R, Dontas AS, Fidanza F, Karvonen MJ, Kimura N, Mohacek I, Nedeljkovic S, Puddu V, Punsar S, Taylor HL, Conti S, Kromhout D, Toshima H . The seven countries study: 2,289 deaths in 15 years Prev Med 1984 13: 141–154.

    Article  CAS  PubMed  Google Scholar 

  22. Cramer K, Paulin S, Werko L . Coronary angiographic findings in correlation with age, body weight, blood pressure, serum lipids, and smoking habits Circulation 1966 33: 888–900.

    Article  CAS  PubMed  Google Scholar 

  23. Anderson AJ, Barboriak JJ, Rimm AA . Risk factors and angiographically determined coronary occlusion Am J Epidemiol 1978 107: 8–14.

    Article  CAS  PubMed  Google Scholar 

  24. Hasin Y, Eisenberg S, Friedlander J, Lewis BS, Gotsman MS . Relationship between extent of coronary artery disease and correlative risk factors Am Heart J 1979 98: 555–561.

    Article  CAS  PubMed  Google Scholar 

  25. Riesen WF, Mordasini R, Salzmann C, Theler A, Gurtner HP . Apoproteins and lipids as discriminators of severity of coronary heart disease Atherosclerosis 1980 37: 157–162.

    Article  CAS  PubMed  Google Scholar 

  26. Freedman DS, Gruchow HW, Anderson AJ, Rimm AA, Barboriak JJ . Relation of triglyceride levels to coronary artery disease: the Milwaukee Cardiovascular Data Registry Am J Epidemiol 1988 127: 1118–1130.

    Article  CAS  PubMed  Google Scholar 

  27. McFarland KF, Boniface ME, Hornung CA, Earnhardt W, Humphries JO . Risk factors and noncontraceptive estrogen use in women with and without coronary disease Am Heart J 1989 117: 1209–1214.

    Article  CAS  PubMed  Google Scholar 

  28. Thompson CJ, Ryu JE, Craven TE, Kahl FR, Crouse JR III . Central adipose distribution is related to coronary atherosclerosis Arterioscler Thromb 1991 11: 327–333.

    Article  CAS  PubMed  Google Scholar 

  29. Takeda Y, Mifune J, Taga K, Hifumi S, Takahashi Y, Yamashita S, Murakami T, Tanaka T . Multiple risk factors in coronary artery disease patients with abnormal glucose tolerance Jpn Heart J 1991 32: 35–43.

    Article  CAS  PubMed  Google Scholar 

  30. Zamboni M, Armellini F, Sheiban I, De Marchi M, Todesco T, Bergamo-Andreis IA, Cominacini L, Bosello O . Relation of body fat distribution in men and degree of coronary narrowings in coronary artery disease Am J Cardiol 1992 70: 1135–1138.

    Article  CAS  PubMed  Google Scholar 

  31. Kambara H, Imoto A, Owada C, Tamaki S, Fudo T, Maetani S . Coronary risk factors used to predict coronary artery disease by logistic regression analysis Jpn Circ J 1992 56: 1199–1205.

    Article  CAS  PubMed  Google Scholar 

  32. Flynn MA, Codd MB, Gibney MJ, Keelan ET, Sugrue DD . Indices of obesity and body fat distribution in arteriographically defined coronary artery disease in men Ir J Med Sci 1993 162: 503–509.

    Article  CAS  PubMed  Google Scholar 

  33. Hauner H, Bognar E, Blum A . Body fat distribution and its association with metabolic and hormonal risk factors in women with angiographically assessed coronary artery disease. Evidence for the presence of a metabolic syndrome Atherosclerosis 1994 105: 209–216.

    Article  CAS  PubMed  Google Scholar 

  34. Salel AF, Riggs K, Mason DT, Amsterdam EA, Zelis R . The importance of type IV hyperlipoproteinemia as a predisposing factor in coronary artery disease Am J Med 1974 57: 897–903.

    Article  CAS  PubMed  Google Scholar 

  35. Naito HK, Greenstreet RL, David JA, Sheldon WL, Shirey EK, Lewis RC, Proudfit WL, Gerrity RG . HDL-cholesterol concentration and severity of coronary atherosclerosis determined by cine-angiography Artery 1980 8: 101–112.

    CAS  PubMed  Google Scholar 

  36. Holmes DR Jr, Elveback LR, Frye RL, Kottke BA, Ellefson RD . Association of risk factor variables and coronary artery disease documented with angiography Circulation 1981 63: 293–299.

    Article  PubMed  Google Scholar 

  37. Wallentin L, Sundin B . Aberrations in lipoprotein lipids in men with coronary artery disease and the influence of obesity, smoking and beta-adrenoceptor blocking drugs Atherosclerosis 1985 54: 241–249.

    Article  CAS  PubMed  Google Scholar 

  38. Adams-Campbell LL, Peniston RL, Kim KS, Mensah E . Body mass index and coronary artery disease in African-Americans Obes Res 1995 3: 215–219.

    Article  CAS  PubMed  Google Scholar 

  39. Rimm EB, Stampfer MJ, Giovannucci E, Ascherio A, Spiegelman D, Colditz GA, Willett WC . Body size and fat distribution as predictors of coronary heart disease among middle-aged and older US men Am J Epidemiol 1995 141: 1117–1127.

    Article  CAS  PubMed  Google Scholar 

  40. Vague J . The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout and calculous disease Am J Clin Nutr 1956 4: 20–34.

    Article  CAS  PubMed  Google Scholar 

  41. Ducimetiere P, Richard J, Cambien F . The pattern of subcutaneous fat distribution in middle-aged men and the risk of coronary heart disease: the Paris Prospective Study Int J Obes 1986 10: 229–240.

    CAS  PubMed  Google Scholar 

  42. Donahue RP, Abbott RD, Bloom E, Reed DM, Yano K . Central obesity and coronary heart disease in men Lancet 1987 i: 821–824.

    Article  Google Scholar 

  43. Prineas RJ, Folsom AR, Kaye SA . Central adiposity and increased risk of coronary artery disease mortality in older women Ann Epidemiol 1993 3: 35–41.

    Article  CAS  PubMed  Google Scholar 

  44. Rexrode KM, Carey VJ, Hennekens CH, Walters EE, Colditz GA, Stampfer MJ, Willett WC, Manson JE . Abdominal adiposity and coronary heart disease in women JAMA 1998 280: 1843–1848.

    Article  CAS  PubMed  Google Scholar 

  45. Folsom AR, Stevens J, Schreiner PJ, McGovern PG . Body mass index, waist/hip ratio, and coronary heart disease incidence in African Americans and whites Am J Epidemiol 1998 148: 1187–1194.

    Article  CAS  PubMed  Google Scholar 

  46. Kissebah AH . Central obesity: measurement and metabolic effects Diabetes Rev 1997 5: 8–20.

    Google Scholar 

  47. Fujioka S, Matsuzawa Y, Tokunaga K, Tarui S . Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity Metabolism 1987 36: 54–59.

    Article  CAS  PubMed  Google Scholar 

  48. Taaffe DR, Lewis B, Marcus R . Regional fat distribution by dual-energy X-ray absorptiometry: comparison with anthropometry and application in a clinical trial of growth hormone and exercise Clin Sci 1994 87: 581–586.

    Article  CAS  Google Scholar 

  49. Taylor RW, Keil D, Gold EJ, Williams SM, Goulding A . Body mass index, waist girth, and waist-to-hip ratio as indexes of total and regional adiposity in women: evaluation using receiver operating characteristics curves Am J Clin Nutr 1998 67: 44–49.

    Article  CAS  PubMed  Google Scholar 

  50. Haarbo J, Gotfredsen A, Hassager C, Christiansen C . Validation of body composition by dual energy X-ray absorptiometry (DEXA) Clin Physiol 1991 11: 331–341.

    Article  CAS  PubMed  Google Scholar 

  51. Svendsen OL, Haarbo J, Hassager C, Christiansen C . Accuracy of measurements of body composition by dual-energy x-ray absorptiometry in vivo Am J Clin Nutr 1993 57: 605–608.

    Article  CAS  PubMed  Google Scholar 

  52. Pearson TA, Derby CA . Invited commentary: should arteriographic case-control studies be used to identify causes of atherosclerotic coronary artery disease? Am J Epidemiol 1991 134: 123–128.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    K Tanaka, H Kodama, S Sasazuki, K Yoshimasu, Y Liu, M Washio, S Tokunaga & S Kono

  2. Department of Cardiology, Tokushukai Fukuoka Medical Center, Kasuga, Japan

    H Arai

  3. Division of Cardiology, National Kyushu Medical Center Hospital, Fukuoka, Japan

    S Koyanagi & K Hiyamuta

  4. Division of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan

    Y Doi, T Kawano, O Nakagaki & K Takada

  5. The Second Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan

    T Nii, K Shirai, M Ideishi & K Arakawa

  6. Reasearch Institute of Angiocardiology and Cardiovascular Clinic, Faculty of Medicine Kyushu University, Fukuoka, Japan

    M Mohri & A Takeshita

Authors
  1. K Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H Kodama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S Sasazuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K Yoshimasu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Y Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Washio
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S Tokunaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S Kono
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. H Arai
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S Koyanagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. K Hiyamuta
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Y Doi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. T Kawano
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. O Nakagaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. K Takada
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. T Nii
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. K Shirai
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. M Ideishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. K Arakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. M Mohri
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. A Takeshita
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K Tanaka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tanaka, K., Kodama, H., Sasazuki, S. et al. Obesity, body fat distribution and coronary atherosclerosis among Japanese men and women. Int J Obes 25, 191–197 (2001). https://doi.org/10.1038/sj.ijo.0801478

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0801478

Keywords

This article is cited by

Search

Advanced search

Quick links