Department of Radiology, Mackay Memorial Hospital, Taipei, Taiwan.
Eur J Radiol. 2012 Apr;81(4):749-56. doi: 10.1016/j.ejrad.2011.01.035. Epub 2011 Feb 21.
Coronary atherosclerosis has traditionally been proposed to be associated with several cardiovascular risk factors and anthropometric measures. However, clinical data regarding the independent value of visceral adipose tissue in addition to such traditional predictors remains obscure.
We subsequently studied 719 subjects (age: 48.1±8.3 years, 25% females) who underwent multidetector computed tomography (MDCT) for coronary calcium score (CCS) quantification. Baseline demographic data and anthropometric measures were taken with simultaneous body fat composition estimated. Visceral adipose tissue of pericardial and thoracic peri-aortic fat was quantified by MDCT using TeraRecon Aquarius workstation (San Mateo, CA). Traditional cardiovascular risk stratification was calculated by metabolic (NCEP ATP III) and Framingham (FRS) scores and high-sensitivity CRP (Hs-CRP) was taken to represent systemic inflammation. The independent value of visceral adipose tissue to systemic inflammation and CCS was assessed by utilizing multivariable regression analysis.
Of all subjects enrolled in this study, the mean values for pericardial and peri-aortic adipose tissue were 74.23±27.51 and 7.23±3.69ml, respectively. Higher visceral fat quartile groups were associated with graded increase of risks for cardiovascular diseases. Both adipose burdens strongly correlated with anthropometric measures including waist circumference, body weight and body mass index (all p<0.001). In addition, both visceral amount correlates well with ATP and FRS scores, all lipid profiles and systemic inflammation marker in terms of Hs-CRP (all p<0.001). After adjustment for baseline variables, both visceral fat were independently related to Hs-CRP levels (all p<0.05), but only pericardial fat exerted independent role in coronary calcium deposit.
Both visceral adipose tissues strongly correlated with systemic inflammation beyond traditional cardiovascular risks and anthropometric measures, though only pericardial fat exerted independent role in coronary calcium deposit. Our data suggested that visceral adipose tissue may thus contribute to systemic inflammation and play an independent role in the pathogenesis of atherosclerosis.
冠状动脉粥样硬化传统上与多种心血管危险因素和人体测量学指标相关。然而，关于内脏脂肪组织在传统预测因素之外的独立价值的临床数据仍然不清楚。
我们随后研究了 719 名（年龄：48.1±8.3 岁，25%为女性）接受多排螺旋 CT（MDCT）进行冠状动脉钙评分（CCS）定量的患者。同时测量了基线人口统计学数据和人体测量学指标，并同步估计了体脂成分。使用 TeraRecon Aquarius 工作站（加利福尼亚州圣马特奥）通过 MDCT 对心包和胸主动脉周围脂肪的内脏脂肪组织进行定量。通过代谢（NCEP ATP III）和弗雷明汉（FRS）评分计算传统心血管风险分层，并测量高敏 C 反应蛋白（Hs-CRP）以代表全身炎症。通过多元回归分析评估内脏脂肪组织对全身炎症和 CCS 的独立价值。
在本研究中纳入的所有患者中，心包和胸主动脉周围脂肪的平均值分别为 74.23±27.51ml 和 7.23±3.69ml。较高的内脏脂肪四分位组与心血管疾病风险的逐渐增加相关。两种脂肪负担均与包括腰围、体重和体重指数在内的人体测量学指标强烈相关（均 P<0.001）。此外，两种内脏脂肪量与 ATP 和 FRS 评分、所有血脂谱以及作为 hs-CRP 的全身炎症标志物均密切相关（均 P<0.001）。在校正基线变量后，两种内脏脂肪均与 hs-CRP 水平独立相关（均 P<0.05），但只有心包脂肪在外周动脉粥样硬化的发生中起独立作用。
内脏脂肪组织与传统心血管危险因素和人体测量学指标以外的全身炎症密切相关，尽管只有心包脂肪在外周动脉粥样硬化的发生中起独立作用。我们的数据表明，内脏脂肪组织可能会导致全身炎症，并在动脉粥样硬化的发病机制中发挥独立作用。
