Until recently the relation between obesity and coronary heart disease was viewed as indirect, ie, through covariates related to both obesity and coronary heart disease risk,12 including hypertension; dyslipidemia, particularly reductions in HDL cholesterol; and impaired glucose tolerance or non–insulin-dependent diabetes mellitus. Insulin resistance and accompanying hyperinsulinemia are typically associated with these comorbidities.13 Although most of the comorbidities relating obesity to coronary artery disease increase as BMI increases, they also relate to body fat distribution. Long-term longitudinal studies, however, indicate that obesity as such not only relates to but independently predicts coronary atherosclerosis.9 14 15 This relation appears to exist for both men and women with minimal increases in BMI. In a 14-year prospective study, middle-aged women with a BMI >23 but 25 but
Posted on: Wed, 08 Oct 2014 00:29:03 +0000
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