腹部内脏和皮下脂肪组织对心脏代谢危险因素的影响：杰克逊心脏研究。
Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study.
机构信息
Jackson Heart Study, University of Mississippi Medical Center, 350 West Woodrow Wilson Drive, Jackson, Mississippi 39213-4505, USA.
出版信息
J Clin Endocrinol Metab. 2010 Dec;95(12):5419-26. doi: 10.1210/jc.2010-1378. Epub 2010 Sep 15.
OBJECTIVE
Obesity is a major driver of cardiometabolic risk. Abdominal visceral adipose tissue (VAT) and sc adipose tissue (SAT) may confer differential metabolic risk profiles. We investigated the relations of VAT and SAT with cardiometabolic risk factors in the Jackson Heart Study cohort.
METHODS
Participants from the Jackson Heart Study (n=2477; 64% women; mean age, 58 yr) underwent multidetector computed tomography, and the volumetric amounts of VAT and SAT were assessed between 2007 and 2009. Cardiometabolic risk factors were examined by sex in relation to VAT and SAT.
RESULTS
Men had a higher mean volume of VAT (873 vs. 793 cm3) and a lower mean volume of SAT (1730 vs. 2659 cm3) than women (P=0.0001). Per 1-sd increment in either VAT or SAT, we observed elevated levels of fasting plasma glucose and triglyceride, lower levels of high-density lipoprotein-cholesterol, and increased odds ratios for hypertension, diabetes, and metabolic syndrome. The effect size of VAT in women was larger than that of SAT [fasting plasma glucose, 5.51±1.0 vs. 3.36±0.9; triglyceride, 0.17±0.01 vs. 0.05±0.01; high-density lipoprotein-cholesterol, -5.36±0.4 vs. -2.85±0.4; and odds ratio for hypertension, 1.62 (1.4-1.9) vs. 1.40 (1.2-1.6); diabetes, 1.82 (1.6-2.1) vs. 1.58 (1.4-1.8); and metabolic syndrome, 3.34 (2.8-4.0) vs. 2.06 (1.8-2.4), respectively; P<0.0001 for difference between VAT and SAT]. Similar patterns were also observed in men. Furthermore, VAT remained associated with most risk factors even after accounting for body mass index (P ranging from 0.006-0.0001). The relationship of VAT to most risk factors was significantly different between women and men.
CONCLUSIONS
Abdominal VAT and SAT are both associated with adverse cardiometabolic risk factors, but VAT remains more strongly associated with these risk factors. The results from this study suggest that relations with cardiometabolic risk factors are consistent with a pathogenic role of abdominal adiposity in participants of African ancestry.
目的
肥胖是心血管代谢风险的主要驱动因素。腹部内脏脂肪组织（VAT）和皮下脂肪组织（SAT）可能具有不同的代谢风险特征。我们在 Jackson 心脏研究队列中调查了 VAT 和 SAT 与心血管代谢风险因素的关系。
方法
Jackson 心脏研究的参与者（n=2477；64%为女性；平均年龄 58 岁）接受了多排螺旋 CT 检查，2007 年至 2009 年间评估了 VAT 和 SAT 的体积量。按性别检查了 VAT 和 SAT 与心血管代谢风险因素的关系。
结果
男性的 VAT 平均体积（873cm3）高于女性（793cm3），SAT 平均体积（1730cm3）低于女性（2659cm3）（P=0.0001）。VAT 或 SAT 每增加 1 个标准差，我们观察到空腹血糖和甘油三酯水平升高，高密度脂蛋白胆固醇水平降低，高血压、糖尿病和代谢综合征的比值比增加。女性 VAT 的效应量大于 SAT [空腹血糖，5.51±1.0 对 3.36±0.9；甘油三酯，0.17±0.01 对 0.05±0.01；高密度脂蛋白胆固醇，-5.36±0.4 对-2.85±0.4；高血压的比值比，1.62（1.4-1.9）对 1.40（1.2-1.6）；糖尿病，1.82（1.6-2.1）对 1.58（1.4-1.8）；代谢综合征，3.34（2.8-4.0）对 2.06（1.8-2.4）；P<0.0001，VAT 和 SAT 之间的差异）。男性也观察到类似的模式。此外，即使考虑到体重指数（BMI），VAT 仍与大多数风险因素相关（P 范围从 0.006 到 0.0001）。VAT 与大多数风险因素的关系在女性和男性之间有显著差异。
结论
腹部 VAT 和 SAT 均与不良心血管代谢风险因素相关，但 VAT 与这些风险因素的相关性更强。这项研究的结果表明，与心血管代谢风险因素的关系与腹部脂肪堆积在非裔参与者中的致病作用一致。
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