449-P: Impact of Body Mass Index (BMI) and Waist Circumference (WC) on Coronary Artery Disease (CAD) in Japanese with and without Diabetes Mellitus (DM)

BMI ≥25.0 and WC ≥90 are components of the International Diabetes Federation (IDF) definition of metabolic syndrome for Asians. We have investigated more suitable BMI and WC levels for risk of CAD using large-scale nationwide claims data on people with and without DM in the same cohort. The sample included 157,220 Japanese men 18-72 years of age without a known history of CAD at baseline (DM: 15,465 patients, non-DM: 141,755 patients). Multivariate Cox regression model examined the association of BMI/WC categories and their combination with CAD. During the study period (median follow-up 5.3 y), 662 and 332 CAD events occurred in non-DM and DM, respectively. Cox regression model showed that BMI ≥22.5 and WC ≥80 conferred a 1.29 (1.07-1.55), and 1.23 (1.00-1.50) times increased risk of CAD, respectively, in non-DM but that those relationships disappeared in people with DM (HR, 0.96 (0.71-1.29) for BMI and 1.13 (0.78-1.62) for WC. Stratified analysis of 4 groups of combinations of BMI and WC showed that in non-DM with BMI ≥22.5/WC ≥80 the risk of future CAD was significantly increased compared with non-DM with BMI In summary, lower BMI and WC values can predict CAD in individuals without DM whereas their influence was modest in people with DM. Disclosure T. Komatsu: None. K. Fujihara: None. M.H. Yamada: None. T. Sato: None. M. Kitazawa: None. M. Yamamoto: None. H. Seida: None. N. Yamanaka: None. Y. Matsubayashi: None. T. Yamada: None. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.