Onat Altan, Ayhan Erkan, Hergenç Gülay, Can Günay, Barlan M Metin
Turkish Society of Cardiology, Istanbul, Turkey.
Metabolism. 2009 Jul;58(7):963-70. doi: 10.1016/j.metabol.2009.02.029.
We investigated among sexes the associations of visceral adipose tissue area (VAT) and body fat mass with smoking status, atherogenic dyslipidemia, inflammatory markers, insulin resistance, and blood pressure (BP). A random sample of the Turkish adult population consisting of 157 middle-aged men and women was evaluated cross-sectionally and partly prospectively. Although men were not influenced significantly, smoking vs never-smoking women had 4 years later a lower VAT (by 31 cm(2), P = .005). Fat mass was significantly correlated with homeostasis model, C-reactive protein, and BP in both sexes, although not with atherogenic dyslipidemia as was VAT. Compared with men, women had lower VAT (P < .01) and, because of interaction of sex and smoking (P = .06), tended to be less susceptible to accumulation of VAT per kilogram body fat mass. In linear regression models comprising 7 variables, VAT was associated in men with systolic BP, apolipoprotein B, and C-reactive protein (each P = .04) and was associated in women with age, smoking status, and high-density lipoprotein cholesterol (each P <or= .01). Significant positive correlations of VAT were obtained with future systolic BP in either sex (P < .03). Body fat mass and visceral fat accumulation are inhibited by cigarette smoking in women. Markers of insulin resistance and inflammation are independently associated with visceral fat marginally in women but significantly in men. Visceral fat is better associated than fat mass with atherogenic dyslipidemia and, in men, with apolipoprotein B. Thus, sex interacts with the dynamics of cardiometabolic risk.
我们研究了内脏脂肪组织面积(VAT)和体脂量在不同性别中与吸烟状况、致动脉粥样硬化性血脂异常、炎症标志物、胰岛素抵抗及血压(BP)之间的关联。对由157名中年男性和女性组成的土耳其成年人群随机样本进行了横断面评估及部分前瞻性评估。尽管男性受影响不显著,但吸烟女性与从不吸烟女性相比,4年后VAT较低(低31平方厘米,P = 0.005)。体脂量在两性中均与稳态模型、C反应蛋白及血压显著相关,不过不像VAT那样与致动脉粥样硬化性血脂异常相关。与男性相比,女性的VAT较低(P < 0.01),并且由于性别与吸烟的相互作用(P = 0.06),每千克体脂量的VAT积累倾向于更不易发生。在包含7个变量的线性回归模型中,男性的VAT与收缩压、载脂蛋白B及C反应蛋白相关(各P = 0.04),女性的VAT与年龄、吸烟状况及高密度脂蛋白胆固醇相关(各P≤0.01)。在任一性别中,VAT与未来收缩压均呈显著正相关(P < 0.03)。吸烟可抑制女性的体脂量和内脏脂肪积累。胰岛素抵抗和炎症标志物在女性中与内脏脂肪仅有边缘性独立关联,而在男性中则显著相关。与体脂量相比,内脏脂肪与致动脉粥样硬化性血脂异常的关联性更好,在男性中与载脂蛋白B的关联性也更好。因此,性别与心脏代谢风险的动态变化相互作用。