Open Access Maced J Med Sci electronic publication ahead of print, published on November 30, 2017 as https://doi.org/10.3889/oamjms.2017.211 _______________________________________________________________________________________________________________________________ Open Access Maced J Med Sci. 1 ID Design 2012/DOOEL Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. https://doi.org/10.3889/oamjms.2017.211 eISSN: 1857-9655 Clinical Science Assessment of the Correlation between Severity of Coronary Artery Disease and Waist–Hip Ratio Premtim Rashiti 1,2 , Ibrahim Behluli 2 , Albiona Rashiti Bytyqi 3* 1 Cardiology Clinic, University Clinical Center of Kosovo, Prishtina, Kosovo; 2 Department of Anatomy, University Clinical Center of Kosovo, Prishtina, Kosovo; 3 Department of Epidemiology, National Institute of Public Health in Kosovo, Prishtina, Kosovo Citation: Rashiti P, Behluli I, Bytyqi AR. Assessment of the Correlation between Severity of Coronary Artery Disease and Waist–Hip Ratio. Open Access Maced J Med Sci. https://doi.org/10.3889/oamjms.2017.211 Keywords: waist/hip ratio; coronary artery disease; Gensini. *Correspondence: Albiona Rashiti Bytyçi, MD. Faculty of Medicine, University of Prishtina, Kosovo. Phone: +37744578822; Email: albionar@gmail.com Received: 05-Oct-2017; Revised: 30-Oct-2017; Accepted: 05-Nov-2017; Online first: 30-Nov-2017 Copyright: © 2017 Premtim Rashiti, Ibrahim Behluli, Albiona Rashiti Bytyqi. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). Funding: This research did not receive any financial support. Competing Interests: The authors have declared that no competing interests exist. Abstract AIM: This study was conducted to investigate the correlation between waist/hip ratio (WHR) as a measurement of obesity and severity of coronary artery disease (CAD) assessed by angiography in Kosovo. METHODS: The study included 82 patients with suspected or known CAD who were referred for coronary angiography. All patients were subjected to full individual medical history, clinical examination including measurement of arterial blood pressure, body weight, height, body mass index (BMI), waist circumference, hip circumference, waist/hip ratio, and waist/height ratio. Coronary angiography was performed using standard techniques to determine the presence and severity of coronary artery lesions with the Gensini score. RESULTS: Among the 82 patients in the study, the mean age in the CAD group was 66.76 ± 9.12 years and the mean age in the non-CAD group was 64.80 ± 8.30 years. Patients in the CAD group had a mean BMI of 28.17 ± 3.32 kg/m 2 and those in the non-CAD group had a mean BMI of 28.76 ± 4.68 kg/m 2 . Patients in the CAD group had a mean waist/height ratio of 1.76 ± 7.56 and those in the non-CAD group had a mean waist/height ratio of 0.57 ± 0.08. Patient in the CAD group had a mean waist/hip ratio of 0.93 ± 0.06 and those in the non-CAD group had a mean waist/hip ratio of 0.88 ± 0.07. Thirty-seven patients (45.1%) had no coronary artery disease (Gensini score = 0), 15 (18.3%) had mild disease (Gensini score = 1-32), 14 (17.1%) had moderate disease (Gensini score = 32-58), and 16 (19.5%) had severe disease (Gensini score ≥ 58). CONCLUSION: There was a significant positive correlation between waist/hip ratio and presence of CAD in Kosovar patients. Introduction Obesity is a growing health problem in most developed and in some developing countries. It is a very important risk factor for cardiovascular diseases as well as for type 2 diabetes mellitus and hypertension. Different methods exist for clinical evaluation of obesity. The body mass index (BMI), waist circumference (WC), waist/hip ratio (WHR), and waist/height ratio (WHtR) are some of the clinical tools enabling health teams to evaluate obesity and fat distribution. A central fat distribution is considered more atherogenic than peripheral obesity and attention has been paid to methods that can clinically evaluate central obesity [1]. The incidence of obesity is increasing in developing countries because of the westernization of diet and lifestyle [2]. Obesity is a proven independent risk factor for CAD in both sexes, and is in general a growing health problem [3-5]. Body weight, BMI, WC, and WHR are primary methods used to determine obesity. While BMI reflects general obesity, WC and WHR are related to central-type obesity, where body fat is primarily located in the abdomen. Prospective epidemiological studies have revealed that central obesity (determined by WC and WHR) is more relevant to CAD risk compared to general obesity (determined by BMI). While WHR is used commonly to evaluate central obesity, WC is shown to have a better correlation with abdominal fat localization (6-9). However, it also has been argued that BMI does not adequately reflect body fat distribution, and abdominal obesity, which captures the distribution of fat mass, may be an even more important predictor of CAD [10, 11]. In epidemiological settings WC, WHR, and WHtR are used as markers of visceral fat mass or abdominal adiposity to assess CAD risk.