Relation of body fat categories by Gallagher classification and by continuous variables to mortality in patients with coronary heart disease

De Schutter, Alban, Lavie, Carl J., Patel, Dharmendrakumar A., Artham, Surya M. and Milani, Richard V. (2013) Relation of body fat categories by Gallagher classification and by continuous variables to mortality in patients with coronary heart disease. American Journal of Cardiology, 111 5: 657-660. doi:10.1016/j.amjcard.2012.11.013


Author De Schutter, Alban
Lavie, Carl J.
Patel, Dharmendrakumar A.
Artham, Surya M.
Milani, Richard V.
Title Relation of body fat categories by Gallagher classification and by continuous variables to mortality in patients with coronary heart disease
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
1879-1913
Publication date 2013-03
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2012.11.013
Volume 111
Issue 5
Start page 657
End page 660
Total pages 4
Place of publication Bridgewater, NJ United States
Publisher Excerpta Medica
Collection year 2014
Language eng
Formatted abstract
Although obesity is a coronary heart disease risk factor, in cohorts of patients with coronary heart disease, an "obesity paradox" exists whereby patients with obesity have a better prognosis than do leaner patients. Obesity is generally defined by body mass index, with relatively little described regarding body fat (BF). In this study, 581 consecutive patients with coronary heart disease divided into the Gallagher BF categories of underweight (n = 12), normal (n = 189), overweight (n = 214), and obese (n = 166) were evaluated, and 3-year mortality was assessed using the National Death Index. Mortality was U shaped, being highest in the underweight group (25%, p <0.0001 vs all groups) and lowest in the overweight group (2.3%), with intermediate mortality in the normal-BF (6.4%, p = 0.02 vs overweight) and obese (3.6%) groups. In multiple regression analysis, high BF (odds ratio 0.89, 95% confidence interval 0.82 to 0.95) and higher Gallagher class (odds ratio 0.46, 95% confidence interval 0.25 to 0.84) were independent predictors of lower mortality. In conclusion, on the basis of Gallagher BF, an obesity paradox exists, with the highest mortality in the underweight and normal-BF groups and the lowest mortality in the overweight group. Lower BF as a continuous variable and by Gallagher classification as a categorical value were independent predictors of higher mortality.
Keyword Obesity Paradox
Mass Index
Cardiorespiratory Fitness
Muscular Strength
Artery Disease
Cardiovascular disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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