Cardiovascular Prevention & Rehabilitation, Swiss Cardiovascular Centre Bern, University Hospital and University of Bern, 3010 Bern, Switzerland.
Swiss Med Wkly. 2011 Feb 3;141:w13153. doi: 10.4414/smw.2011.13153. eCollection 2011.
The burden of abdominal obesity (AO) and its association with other cardiovascular risk factors is not known in coronary artery disease (CAD) patients attending cardiac rehabilitation (CR). The aim of this study was, therefore, to investigate the prevalence of AO and differences in cardiovascular risk factors between AO and non-AO patients.
415 consecutive male CAD patients (mean age 58 ± 11 years) attending a three-month outpatient CR programme were assessed. Differences in cardiovascular risk profile, including blood lipids, psychosocial and socioeconomic status and exercise capacity, were compared in relation to AO and checked for obesity measured by body-mass index (BMI) in a multivariate analysis.
Mean waist circumference was 102 ± 11 cm. Patients of lower educational level had a higher prevalence of AO (p = 0.021) than patients with a higher educational level. AO was significantly associated with diabetes (p = 0.003) and hypertension (p <0.001). In AO patients, HDL-C levels were lower (p <0.001) and triglyceride levels higher (p = 0.006) than in non-AO patients. There was no difference in exercise capacity between AO and non-AO patients, but AO patients had a higher resting heart rate (p = 0.021).
AO is highly prevalent in CAD patients attending CR. AO is, independently of BMI, associated with metabolic lipid disorders and autonomic cardiovascular dysregulation, suggesting an increased cardiovascular risk. AO patients therefore need particular attention during CR and follow-up care.
在接受心脏康复（CR）的冠心病（CAD）患者中，腹部肥胖（AO）的负担及其与其他心血管危险因素的关系尚不清楚。因此，本研究旨在调查 AO 的患病率以及 AO 患者与非 AO 患者之间心血管危险因素的差异。
对 415 例连续的男性 CAD 患者（平均年龄 58 ± 11 岁）进行了评估。根据 AO 情况，比较了心血管风险状况（包括血脂、心理社会和社会经济地位以及运动能力）的差异，并在多变量分析中检查了通过体重指数（BMI）测量的肥胖情况。
平均腰围为 102 ± 11 cm。文化程度较低的患者 AO 患病率较高（p = 0.021）。AO 与糖尿病（p = 0.003）和高血压（p <0.001）显著相关。在 AO 患者中，HDL-C 水平较低（p <0.001），甘油三酯水平较高（p = 0.006）。与非 AO 患者相比，AO 患者的运动能力没有差异，但静息心率较高（p = 0.021）。
在接受 CR 的 CAD 患者中，AO 患病率很高。AO 与代谢脂质紊乱和自主心血管失调独立相关，提示心血管风险增加。因此，AO 患者在 CR 和随访期间需要特别关注。
