Al Suwaidi J, Higano S T, Holmes D R, Lennon R, Lerman A
Center for Coronary Physiology and Imaging, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
J Am Coll Cardiol. 2001 May;37(6):1523-8. doi: 10.1016/s0735-1097(01)01212-8.
This study evaluates the impact of obesity on coronary endothelial function in patients with normal or mild coronary artery disease.
The American Heart Association (AHA) has recently classified obesity as a modifiable risk factor for coronary heart disease.
A total of 397 consecutive patients with normal or mildly diseased coronary arteries at angiography underwent coronary vascular reactivity evaluation using intracoronary adenosine, acetylcholine and nitroglycerin. Patients were divided into three groups based on the body mass index (BMI): Group 1, patients with a BMI <25 (n = 117, normal weight); Group 2, patients with a BMI 25-30 (n = 149, overweight) and Group 3, patients with a BMI >30 (n = 131, obese).
There were no significant differences among the groups in regard to other cardiovascular risk factors, except that overweight but not obese patients were significantly older than normal-weight patients (47 +/- 1 years in Group 1, 53 +/- 1 years in Group 2 and 50 +/- 1 years in Group 3, p < 0.001). The percent change of coronary blood flow to acetylcholine (%delta CBF Ach) was significantly lower in the obese patients than in the normal-weight group (85.2 +/- 12.0% in Group 1, 63.7 +/- 10.0% in Group 2 and 38.1 +/- 9.6% in Group 3, p = 0.009). By multivariate analysis, overweight (odds ratio, 1.55; 95% confidence interval, 1.2-2.0) and obesity (odds ratio, 2.41; 95% confidence interval, 1.5-4.0) status were independently associated with impaired coronary endothelial function.
The study demonstrates that obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries.
本研究评估肥胖对冠状动脉正常或轻度病变患者冠状动脉内皮功能的影响。
美国心脏协会（AHA）最近将肥胖列为冠心病的可改变风险因素。
共有397例在血管造影时冠状动脉正常或轻度病变的连续患者，使用冠状动脉内腺苷、乙酰胆碱和硝酸甘油进行冠状动脉血管反应性评估。根据体重指数（BMI）将患者分为三组：第1组，BMI<25的患者（n = 117，正常体重）；第2组，BMI为25 - 30的患者（n = 149，超重）；第3组，BMI>30的患者（n = 131，肥胖）。
除超重但非肥胖患者的年龄显著大于正常体重患者外（第1组为47±1岁，第2组为53±1岁，第3组为50±1岁，p<0.001），各组在其他心血管危险因素方面无显著差异。肥胖患者冠状动脉血流对乙酰胆碱的变化百分比（%δCBF Ach）显著低于正常体重组（第1组为85.2±12.0%，第2组为63.7±10.0%，第3组为38.1±9.6%，p = 0.009）。多因素分析显示，超重（比值比，1.55；95%置信区间，1.2 - 2.0）和肥胖（比值比，2.41；95%置信区间，1.5 - 4.0）状态与冠状动脉内皮功能受损独立相关。
该研究表明，肥胖与冠状动脉正常或轻度病变患者的冠状动脉内皮功能障碍独立相关。
