Body composition in coronary artery disease in KONKAN region of India-Is non- obesity an indicator of Coronary Artery Disease?

Description

 Background
India is witnessing a rising prevalence of non communicable diseases like diabetes, hypertension, coronary artery disease. This is attributed to rapid nutrition and lifestyle transition taking place since last 2 decades. Obesity is a well known independent risk factor   but very little information is available about role of leanness (low BMI). We investigated whether non-obesity could be an independent risk factor for Coronary artery disease in a rural clinic in KONKAN.
 
 Methods
 In a cross sectional study we studied body composition of 300 patients (207 men) who underwent Coronary angiography in a rural hospital in KONKAN region.  History of diabetes, hypertension and history smoking, tobacco chewing was recorded. Body composition was estimated using bio-impedance analyser. Based on results of coronary angiography, we generated a SYNTAX score derived by number of vessels involved and classified them into groups of severity of coronary artery disease (CAD).  
 
Results
There were 95 (31 %) diabetes and 189 (63%) hypertensive patients in the sample and 60% of them smoked or chewed tobacco. There were 43 (28 males) patients with SYNTAX score of zero. Among those with coronary artery disease (n=257) increasing severity of CAD   was associated with lower body weight, BMI, body fat percentage, and body fat mass and ejection fraction as against positive trend for lean mass and visceral fat.
 
Conclusion
BMI, fat mass decreased with severity of CAD while lean mass and visceral fat increased. We observed high proportion of CAD in underweight and lean KONKAN adults. These findings need further investigations