Respiratory Care Clinic, Nippon Medical School, Kudan-Minami, Chiyoda-ku, Tokyo, Japan.
Int J Chron Obstruct Pulmon Dis. 2011;6:423-30. doi: 10.2147/COPD.S22885. Epub 2011 Aug 8.
Previous studies have suggested links between chronic obstructive pulmonary disease (COPD), cardiovascular disease, and abdominal obesity. Although abdominal visceral fat is thought to be associated with cardiovascular risk factors, the degree of visceral fat accumulation in patients with COPD has not been directly studied. The aim of this study was to investigate the abdominal visceral fat accumulation and the association between visceral fat and the severity and changes in emphysema in COPD patients.
We performed clinical and laboratory tests, including pulmonary function, dyspnea score, and the six-minute walking test in COPD patients (n = 101) and control, which included subjects with a smoking history but without airflow obstruction (n = 62). We used computed tomography to evaluate the abdominal visceral fat area (VFA), subcutaneous fat area (SFA), and the extent of emphysema.
The COPD group had a larger VFA than the control group. The prevalence of non-obese subjects with an increased VFA was greater in the Global Initiative for Chronic Obstructive Lung Disease Stages III and IV than in the other stages of COPD. The extent of emphysema was inversely correlated with waist circumference and SFA. However, VFA did not decrease with the severity of emphysema. VFA was positively correlated with the degree of dyspnea.
COPD patients have excessive visceral fat, which is retained in patients with more advanced stages of COPD or severe emphysema despite the absence of obesity.
先前的研究表明慢性阻塞性肺疾病（COPD）、心血管疾病和腹部肥胖之间存在关联。尽管腹部内脏脂肪被认为与心血管危险因素有关，但 COPD 患者内脏脂肪的积累程度尚未得到直接研究。本研究旨在探讨 COPD 患者腹部内脏脂肪的积累情况，以及内脏脂肪与 COPD 严重程度和肺气肿变化的关系。
我们对 COPD 患者（n=101）和对照组（n=62）进行了临床和实验室检查，包括肺功能、呼吸困难评分和六分钟步行试验。我们使用计算机断层扫描评估了腹部内脏脂肪面积（VFA）、皮下脂肪面积（SFA）和肺气肿的程度。
COPD 组的 VFA 大于对照组。在 Global Initiative for Chronic Obstructive Lung Disease 分期 III 和 IV 的 COPD 患者中，非肥胖且 VFA 增加的患者比例大于其他 COPD 分期。肺气肿的程度与腰围和 SFA 呈负相关。然而，VFA 并没有随着肺气肿的严重程度而降低。VFA 与呼吸困难的严重程度呈正相关。
COPD 患者有过多的内脏脂肪，尽管没有肥胖，但在 COPD 更严重阶段或严重肺气肿的患者中仍保留着内脏脂肪。
