Background: Obesity and homocysteine are important risk factors for cardiovascular disease. The relation between pattern of obesity and homocysteine is unclear. The objective of this study was to investigate the relation between pattern of obesity and plasma total homocysteine ( tHcy) level in male patients with coronary artery disease ( CAD). Methods: A total of 63 male patients (mean age 66.2 years) with angiographically documented CAD were enrolled. Overnight fasting blood samples were measured for plasma tHcy, serum folic acid and serum vitamin B-12 levels. Anthropometric measurements included waist-to-hip ratio (WHR ) and body mass index (BMI). Results: The mean WHIR was 0.90 +/- 0.05, mean BMI 24.6 +/- 3.3 kg/m(2) and the mean plasma tHcy level 11.6 +/- 3.2 mu mol/L. In univariate analysis, plasma tHcy level correlated significantly with serum vitamin B12 level, serum folic acid level, WHR, estimated creatinine clearance, aspirin use and fibrate use. There was no significant association between plasma tHcy level and BMI. In multivariate analysis, only WHR (beta-value 22.263, p