Zamboni M, Armellini F, Sheiban I, De Marchi M, Todesco T, Bergamo-Andreis I A, Cominacini L, Bosello O
Institute of Internal Medicine, Policlinico di Borgo Roma, University of Verona, Italy.
Am J Cardiol. 1992 Nov 1;70(13):1135-8. doi: 10.1016/0002-9149(92)90043-x.
This study evaluates the relation between body fat distribution and severity of coronary artery disease (CAD). The study sample comprised 33 patients with angiographically demonstrated CAD and 10 angiographically normal control subjects. Body fat distribution was estimated by computed tomography and degree of coronary narrowings by angiographic score. Body weight, body mass index and total and subcutaneous abdominal adipose tissue areas showed no statistical differences in the 2 groups; visceral abdominal adipose tissue area and the visceral to subcutaneous abdominal adipose tissue area ratio were significantly higher in patients with CAD (p < 0.05). There was a significant correlation between visceral fat and triglycerides, apoprotein B and sum of glucose and insulin during glucose oral tolerance test. Sum of insulin during glucose oral tolerance test, visceral abdominal adipose tissue area and visceral/subcutaneous abdominal adipose tissue area ratio correlated significantly with severity of CAD, as evaluated by coronary score in all subjects and in CAD patients alone. Stepwise multiple regression analysis using the coronary score as the dependent variable and anthropometric and metabolic parameters as independent variables shows that in all subjects and in CAD patients alone, visceral/subcutaneous abdominal adipose-tissue area ratio entered the regression first and the sum of insulin during glucose oral tolerance test second. The results suggest that visceral abdominal adipose tissue area and visceral to subcutaneous abdominal adipose tissue area ratio may be cardiovascular risk factors.
本研究评估了体脂分布与冠状动脉疾病(CAD)严重程度之间的关系。研究样本包括33例经血管造影证实患有CAD的患者和10例血管造影正常的对照受试者。通过计算机断层扫描估计体脂分布,通过血管造影评分评估冠状动脉狭窄程度。两组的体重、体重指数以及腹部总脂肪组织面积和皮下脂肪组织面积均无统计学差异;CAD患者的腹部内脏脂肪组织面积以及腹部内脏与皮下脂肪组织面积之比显著更高(p < 0.05)。在口服葡萄糖耐量试验期间,内脏脂肪与甘油三酯、载脂蛋白B以及葡萄糖和胰岛素之和之间存在显著相关性。在所有受试者以及仅CAD患者中,口服葡萄糖耐量试验期间的胰岛素之和、腹部内脏脂肪组织面积以及内脏/皮下腹部脂肪组织面积之比与CAD严重程度显著相关,CAD严重程度通过冠状动脉评分评估。以冠状动脉评分为因变量、人体测量学和代谢参数为自变量进行逐步多元回归分析表明,在所有受试者以及仅CAD患者中,腹部内脏/皮下脂肪组织面积之比首先进入回归方程,其次是口服葡萄糖耐量试验期间的胰岛素之和。结果表明,腹部内脏脂肪组织面积以及腹部内脏与皮下脂肪组织面积之比可能是心血管危险因素。