Arner P, Bäckdahl J, Hemmingsson P, Stenvinkel P, Eriksson-Hogling D, Näslund E, Thorell A, Andersson D P, Caidahl K, Rydén M
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Int J Obes (Lond). 2015 Feb;39(2):222-7. doi: 10.1038/ijo.2014.118. Epub 2014 Jul 8.
Cardiovascular disease is associated with multiple risk factors including stiff arteries and large adipocytes. Whether the latter two are interrelated is unknown. We aimed to determine whether arterial stiffness is associated with fat cell size and number in subcutaneous or visceral white adipose tissue (WAT).
A cross-sectional study of 120 obese subjects scheduled for bariatric surgery in whom WAT mass and distribution was assessed by dual-X-ray absorptiometry. Biopsies from visceral (greater omentum) and subcutaneous (abdominal) WAT were obtained to calculate fat cell volume and number. Arterial stiffness was determined as aortic pulse wave velocity (PWV).
Visceral adipocyte volume, but not number, was strongly (P<0.0001) and positively correlated with PWV, explaining 20% of the inter-individual variations in this parameter. This relationship remained significant after correction for clinical confounders. PWV correlated positively (r=0.38, P<0.0001) with visceral (but not subcutaneous) WAT mass. Furthermore, PWV was also positively associated with subcutaneous adipocyte volume (r=0.20, P=0.031) and negatively with fat cell number (r=-0.26, P=0.006). However, the relationships between PWV and visceral WAT mass or subcutaneous fat cell size/number became non-significant when controlling for visceral fat cell volume. In a multiple regression analysis to determine the factors that explain variations in PWV, only visceral fat cell volume, age, pulse rate and diastolic blood pressure entered the model, together explaining 42% of the variation in PWV.
Visceral fat cell volume was the only WAT parameter that constituted an independent and significant, positive regressor for arterial stiffness determined by PWV. Although a causal relationship is not established, visceral fat cell volume may explain the well-known correlation between central fat mass, arterial stiffness and cardiovascular risk, at least in severely/morbidly obese subjects.
心血管疾病与多种风险因素相关，包括动脉僵硬和大脂肪细胞。后两者是否相互关联尚不清楚。我们旨在确定动脉僵硬是否与皮下或内脏白色脂肪组织（WAT）中的脂肪细胞大小和数量相关。
对120名计划进行减肥手术的肥胖受试者进行横断面研究，通过双能X线吸收法评估WAT的质量和分布。获取内脏（大网膜）和皮下（腹部）WAT的活检样本以计算脂肪细胞体积和数量。动脉僵硬程度通过主动脉脉搏波速度（PWV）来确定。
内脏脂肪细胞体积而非数量与PWV呈强正相关（P<0.0001），解释了该参数个体间变异的20%。在校正临床混杂因素后，这种关系仍然显著。PWV与内脏（而非皮下）WAT质量呈正相关（r=0.38，P<0.0001）。此外，PWV也与皮下脂肪细胞体积呈正相关（r=0.20，P=0.031），与脂肪细胞数量呈负相关（r=-0.26，P=0.006）。然而，在控制内脏脂肪细胞体积后，PWV与内脏WAT质量或皮下脂肪细胞大小/数量之间的关系变得不显著。在一项多元回归分析中，为了确定解释PWV变异的因素，只有内脏脂肪细胞体积、年龄、脉搏率和舒张压进入模型，共同解释了PWV变异的42%。
内脏脂肪细胞体积是唯一构成由PWV确定的动脉僵硬的独立且显著的正回归变量的WAT参数。尽管尚未建立因果关系，但内脏脂肪细胞体积可能解释了中心脂肪质量、动脉僵硬和心血管风险之间的众所周知的相关性，至少在重度/病态肥胖受试者中如此。
