THE OBESITY PARADOX IN THE COEXISTENCE OF DIABETES AND CORONARY ARTERY DISEASE

Objective: Although obesity is a well-established risk factor for coronary artery disease (CAD), several recent studies have paradoxically demonstrated lower cardiovascular mortality rates among obese individuals. This study aimed to compare the extent of CAD between obese and non-obese diabetic patients and evaluate the presence of the obesity paradox in this population.Materials and Methods: A total of 1,557 patients who underwent coronary angiography were retrospectively screened. Fifty-three diabetic patients were included and divided into two groups according to body mass index (BMI): ≥30 and <30. The groups were matched for age, gender, and other cardiovascular risk factors. The extent of CAD was assessed using the SYNTAX score. Statistical analyses were performed using IBM SPSS Statistics version 27, and a p-value of <0.05 was considered statistically significant.Results: There were no statistically significant differences between the groups (BMI ≥30 vs. <30) regarding age, gender, HbA1c, LDL, total cholesterol, creatinine levels, hypertension, family history, atrial fibrillation, cerebrovascular disease, and smoking status. The SYNTAX score was significantly lower in the obese group (12.67±9.68) compared to the non-obese group (19±12.68) (p=0.046).Conclusion: Among diabetic patients, those who were obese had significantly less extensive and severe CAD compared to their non-obese counterparts, supporting the concept of the obesity paradox.