Heart Institute (InCor) University of Sao Paulo Medical School, Brazil.
Atherosclerosis. 2010 Apr;209(2):481-6. doi: 10.1016/j.atherosclerosis.2009.10.023. Epub 2009 Oct 29.
Visceral abdominal fat has been associated to cardiovascular risk factors and coronary artery disease (CAD). Computed tomography (CT) coronary angiography is an emerging technology allowing detection of both obstructive and nonobstructive CAD adding information to clinical risk stratification. The aim of this study was to evaluate the association between CAD and adiposity measurements assessed clinically and by CT. We prospectively evaluated 125 consecutive subjects (57% men, age 56.0+/-12 years) referred to perform CT angiography. Clinical and laboratory variables were determined and CT angiography and abdominal CT were performed in a 64-slice scanner. CAD was defined as any plaque calcified or not detected by CT angiography. Visceral and subcutaneous adiposity areas were determined at different intervertebral levels. CT angiography detected CAD in 70 (56%) subjects, and no association was found with usual anthropometric adiposity measurements (waist and hip circumferences and body mass index). Otherwise, CT visceral fat areas (VFA) were significantly related to CAD. VFA T12-L1 values > or =145cm(2) had an odds ratio of 2.85 (95% CI 1.30-6.26) and VFA L4-L5 > or =150cm(2) had a 2.87-fold (95% CI 1.31-6.30) CAD risk. The multivariate analysis determined age and VFA T12-L1 as the only independent variables associated to CAD. Visceral fat assessed by CT is an independent marker of CAD determined by CT angiography.
内脏腹部脂肪与心血管危险因素和冠状动脉疾病（CAD）有关。计算机断层扫描（CT）冠状动脉造影是一种新兴技术，可同时检测阻塞性和非阻塞性 CAD，为临床危险分层提供更多信息。本研究旨在评估通过临床和 CT 评估的 CAD 与肥胖测量之间的关联。我们前瞻性评估了 125 例连续患者（57%为男性，年龄 56.0+/-12 岁），这些患者被转介进行 CT 血管造影。确定了临床和实验室变量，并在 64 层扫描仪上进行了 CT 血管造影和腹部 CT。CAD 定义为通过 CT 血管造影检测到的任何斑块钙化或未钙化。在不同的椎间水平确定了内脏和皮下脂肪面积。CT 血管造影在 70 名（56%）患者中检测到 CAD，与常规人体测量肥胖测量（腰围和臀围以及体重指数）没有关联。然而，CT 内脏脂肪面积（VFA）与 CAD 有显著相关性。VFA T12-L1 值>或=145cm(2)的比值比为 2.85（95%置信区间 1.30-6.26），VFA L4-L5>或=150cm(2)的比值比为 2.87（95%置信区间 1.31-6.30）。多变量分析确定年龄和 VFA T12-L1 是与 CAD 相关的唯一独立变量。CT 评估的内脏脂肪是 CT 血管造影确定的 CAD 的独立标志物。
