The effects of body fat distribution on coronary and carotid atherosclerosis: an autopsy study

Epidemic levels of obesity and overweight in today's world are leading to a higher number of mortality and morbidity, especially due to cardiovascular diseases (CVDs). Body fat distribution contributes a great amount to atherosclerosis formation and therefore increased CVD incidence. The present study used the autopsy of 40 healthy-appearing adults who died due to non-cardiac causes to explore the association between atherosclerosis and body fat distribution indices including abdominal fat, visceral fat, subcutaneous fat, and pericardial fat. This cross-sectional study examined the autopsy of 40 individuals of 20 to 50 years old who died due to non-cardiac causes, mostly car accidents, and were sent to the forensic center. Measurement of abdominal fat, visceral fat, subcutaneous fat and heart weight/height ratio as a pericardial fat index in the cadavers was followed by atherosclerosis assessment in the carotid artery, left and right internal and external carotid arteries, as well as right coronary artery (RCA), left anterior descending (LAD) and left circumflex (LCX) coronary arteries based on American Heart Association (AHA) criteria. In order to evaluate the relation between atherosclerosis development and body fat distribution indices, SPSS version 19 was used for multinomial logistic regression analysis in the crude and adjusted models (for age, smoking, LDL-c, HDL-c, HBA1c, and CVD history). The effectiveness of body fat distribution variables along with age, smoking, LDL-c, HDL-c, HBA1c, and CVD history on atherosclerosis was also determined by stepwise forward regression analysis. The average age of the subjects was 29.97 ± 9.84 years. Among 40 performed autopsies only 3 were women. Coronary and carotid atherosclerosis were observed in 50% and 85% of the cadavers, respectively. Logistic regression analysis revealed no link between carotid atherosclerosis and body fat distribution indices. Although, the correlation found between heart weight/height ratio and atherosclerosis in the crude model did not remain significant after the adjustment of other indices, stepwise forward regression analysis resulted in OR = 9.461 and confidence interval = 1.199-74.650. Our results indicated a link between coronary atherosclerosis and heart weight/height ratio. Since coronary and carotid atherosclerosis were not found to be correlated with subcutaneous and visceral fat, further investigation is suggested.