Ryo Miwa, Funahashi Tohru, Nakamura Tadashi, Kihara Shinji, Kotani Kazuaki, Tokunaga Katsuto, Matsuzawa Yuji, Shimomura Iichiro
Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan.
Intern Med. 2014;53(4):299-305. doi: 10.2169/internalmedicine.53.9476.
A cluster of multiple risk factors has been noted to constitute the background of cardiovascular disease. The purpose of this study was to evaluate the relationship between the visceral fat area (VFA) or subcutaneous fat area (SFA) and a cluster of obesity-related cardiovascular risk factors, including hyperglycemia, dyslipidemia and elevated blood pressure, in middle-aged Japanese men and women.
A total of 571 subjects (m=434; f=137; age: 53 ± 9 years) who underwent health examinations with evaluations of body fat distribution using computed tomography scans and assessments of 75-g oral glucose tolerance tests were enrolled in this study.
The VFA and SFA were linearly correlated with the number of risk factors in both men and women. The area under the receiver-operating characteristic curve of VFA (m=0.741, f=0.763) was significantly higher than that of SFA (m=0.636, f=0.689) with respect to the clustering of risk factors (one or more). The men exhibited larger VFA values and smaller SFA values than the women in similar body mass index (BMI) categories. Men with a VFA of ≥100 cm(2) irrespective of BMI and women with a VFA of ≥100 cm(2) and a BMI of ≥25 kg/m(2) demonstrated a high prevalence of diabetes mellitus and impaired glucose tolerance. Men and women with a VFA of ≥100 cm(2) irrespective of BMI demonstrated a high prevalence of type IIb dyslipidemia.
These results suggest that the absolute value of VFA rather than SFA is more closely associated with a cluster of risk factors irrespective of sex and is a good marker for selecting subjects to whom weight reduction should be recommended in order to prevent cardiovascular disease in the general population.
已注意到一组多种风险因素构成心血管疾病的背景。本研究的目的是评估日本中年男性和女性的内脏脂肪面积（VFA）或皮下脂肪面积（SFA）与一组肥胖相关心血管风险因素之间的关系，这些因素包括高血糖、血脂异常和血压升高。
本研究共纳入571名受试者（男性434名；女性137名；年龄：53±9岁），这些受试者接受了健康检查，通过计算机断层扫描评估身体脂肪分布，并进行了75克口服葡萄糖耐量试验评估。
VFA和SFA与男性和女性的风险因素数量均呈线性相关。就风险因素聚集（一个或多个）而言，VFA的受试者工作特征曲线下面积（男性为0.741，女性为0.763）显著高于SFA（男性为0.636，女性为0.689）。在相似的体重指数（BMI）类别中，男性的VFA值较大，SFA值较小。无论BMI如何，VFA≥100 cm²的男性以及VFA≥100 cm²且BMI≥25 kg/m²的女性糖尿病和糖耐量受损的患病率较高。无论BMI如何，VFA≥100 cm²的男性和女性IIb型血脂异常的患病率较高。
这些结果表明，无论性别如何，VFA的绝对值而非SFA与一组风险因素的关联更为密切，并且是在一般人群中选择应建议减重以预防心血管疾病的受试者的良好指标。
