Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
J Atheroscler Thromb. 2012;19(7):657-63. doi: 10.5551/jat.13037. Epub 2012 May 4.
Multiple risk factor syndrome is a target for the prevention of coronary artery disease (CAD). A cluster of multiple risk factors, such as hypertension, glucose intolerance, and/or dyslipidemia, is encountered in Japanese without and with excess visceral fat. The present study investigated the relationship between multiple risk factor accumulation and CAD in Japanese without and with visceral fat accumulation.
The study subjects comprised 257 Japanese with suspected CAD (males/females= 153/ 104), who underwent 64-row multislice computed tomography (CT) coronary angiography and visceral fat area (VFA) measurement by CT. Based on the Japanese criteria for visceral fat accumulation, they were divided into those with VFA <100 and ≥10 cm(2).
In subjects with VFA <100 cm(2), the age- and sex-adjusted odds ratios (ORs) for 2 and 3 risk factors were 5.33 (95% confidence intervals; 1.04-27.38, p=0.0449) and 4.07 (0.72-23.15, p=0.1138), respectively, compared with VFA <100 cm(2) and 0 risk factor set at 1.0 (p=0.0569 for trend). In contrast, the respective ORs for subjects with VFA ≥100 cm(2) were much higher [6.46 (1.25-33.44, p=0.0261) and 20.42 (3.60-115.73, p=0.0007)] (p<0.0001 for trend). The multivariate adjusted model demonstrated a significant relative excess CAD risk of 1.08 (p=0.0484) and 5.01 (p<0.0001) for the interactions of 2 risk factors and VFA ≥100 cm(2), and 3 risk factors and VFA ≥100 cm(2), whereas multiple risk factor accumulation was not related with the increase of CAD risk in subjects with VFA <100 cm(2).
Coexistence of visceral fat and risk factor accumulations is strongly associated with CAD in Japanese.
多种危险因素综合征是冠心病（CAD）的预防目标。在没有和存在过多内脏脂肪的日本人群中，会遇到高血压、葡萄糖耐量异常和/或血脂异常等多种危险因素的聚集。本研究旨在探讨日本人群中无内脏脂肪堆积和存在内脏脂肪堆积时，多种危险因素聚集与 CAD 的关系。
本研究纳入 257 例疑似 CAD 的日本患者（男性/女性=153/104），这些患者接受了 64 层多层螺旋 CT（CT）冠状动脉造影和 CT 内脏脂肪面积（VFA）测量。根据日本内脏脂肪堆积标准，将患者分为 VFA<100cm²和≥10cm²两组。
在 VFA<100cm²的患者中，与 VFA<100cm²且无危险因素设定为 1.0 相比，2 个和 3 个危险因素的年龄和性别校正比值比（OR）分别为 5.33（95%置信区间：1.04-27.38，p=0.0449）和 4.07（0.72-23.15，p=0.1138）（p=0.0569 趋势检验）。相比之下，VFA≥100cm²患者的相应 OR 更高[6.46（1.25-33.44，p=0.0261）和 20.42（3.60-115.73，p=0.0007）]（p<0.0001 趋势检验）。多变量校正模型显示，2 个危险因素和 VFA≥100cm²之间的相互作用和 3 个危险因素和 VFA≥100cm²之间的相互作用具有显著的 CAD 相对过度风险，分别为 1.08（p=0.0484）和 5.01（p<0.0001），而在 VFA<100cm²的患者中，多种危险因素的聚集与 CAD 风险的增加无关。
日本人群中内脏脂肪和危险因素的共存与 CAD 密切相关。
