Lean mass index, body fat and survival in Chinese patients with coronary artery disease

Abstract

Background: 'Obesity paradox' was not consistently observed in Asians with coronary artery disease (CAD). Aim: The study investigated the association between body composition and outcomes in Chinese patients with CAD. Design: Cohort study. Method: A total of 3280 patients with angiographically validated CAD were consecutively included. Body fat (BF) percentage and lean mass index (LMI) were evaluated using the Clińica Universidad de Navarra-Body Adiposity Estimator. The rate of mortality from any cause was compared across groups classified by the quartiles of LMI. Results: During a median period of 24 months, 288 (8.8%) participants died. There was a close association between increasing LMI and reducing mortality rate. However, univariate analyses did not find protective effect of BF on survival. After adjusting for age, sex, diabetes, current smoking, systolic blood pressure, creatinine, white blood cell count, haemoglobin and medication, Cox regression analyses showed that the significant relation between higher quartiles (Q) of LMI and survival benefit (Q4, hazard ratio 0.58 (95% confidence interval: 0.36-0.94) vs. Q3, 0.60 (0.39-0.91) vs. Q2, 0.60 (0.41-0.88) vs. Q1, reference) remained. Conclusion: Low LMI but not BF predicts all-cause mortality in Chinese patients with CAD.