Murakami Yoko, Nagatani Yukihiro, Takahashi Masashi, Ikeda Mitsuru, Miyazawa Itsuko, Morino Katsutaro, Ohkubo Takayoshi, Maegawa Hiroshi, Nitta Norihisa, Sakai Hiroshi, Nota Hiromitsu, Ushio Noritoshi, Murata Kiyoshi
Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Department of Radiology, Shiga University of Medical Science, Seta-tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Atherosclerosis. 2016 Mar;246:374-81. doi: 10.1016/j.atherosclerosis.2015.12.014. Epub 2015 Dec 20.
Renal sinus fat (RSF) behaves as one of the perivascular fats, however RSF volume (RSFV) is considerably affected by visceral adipose tissue volume (VTAV). The ratio of RSFV to VATV (RSFV/VATV ratio) can be an index of regional perivascular fat accumulation corrected for the influence of VATV. The aim of this study was to investigate the relation between RSFV/VATV ratio and coronary artery calcium (CAC) in patients with suspected coronary artery disease.
One hundred and eighty-nine patients (mean age 66.7 ± 10.2; 72% men) underwent ECG-gated cardiac computed tomography (CT) and unenhanced abdominal CT. CAC score (CACS) was assessed using axial CT images. RSFV was measured by partially manipulated segmentation of the right kidney. VATV was automatically quantified in the upper abdomen. Logistic and correlation analyses were performed to examine the correlations between CAC, RSFV/VATV ratio, and risk factors of cardiovascular diseases in total and subgroups classified by the patients' age.
Log-transformed RSFV/VATV ratio was associated with CAC presence in 112 middle-aged patients less than 69 years of age as well as total. This association remained significant after multivariate adjustment only in the middle-aged patients (OR 15.9, 95% CI 1.15-218.8). In total, RSFV/VATV ratio (r = 0.228, p = 0.002) and age (r = 0.316, p < 0.001) correlated with CACS on univariate analyses, but only age correlated on multivariate analyses. RSFV/VATV ratio correlated with CACS in the middle-aged patients (r = 0.418, p < 0.001), as well as on multivariate analyses.
We demonstrated that RSFV/VATV could be an independent risk indicator of CAC in the middle-aged patients.
肾窦脂肪（RSF）是血管周围脂肪之一，然而肾窦脂肪体积（RSFV）受内脏脂肪组织体积（VTAV）影响较大。肾窦脂肪体积与内脏脂肪组织体积之比（RSFV/VATV比值）可作为校正内脏脂肪组织体积影响后的局部血管周围脂肪堆积指标。本研究旨在探讨疑似冠心病患者中RSFV/VATV比值与冠状动脉钙化（CAC）之间的关系。
189例患者（平均年龄66.7±10.2岁；72%为男性）接受心电图门控心脏计算机断层扫描（CT）和非增强腹部CT检查。使用轴向CT图像评估CAC评分（CACS）。通过对右肾进行部分手动分割测量RSFV。在上腹部自动定量测量VTAV。进行逻辑回归和相关性分析，以检验CAC、RSFV/VATV比值与心血管疾病危险因素在总体及按患者年龄分类的亚组中的相关性。
对数转换后的RSFV/VATV比值与112例年龄小于69岁的中年患者以及总体患者的CAC存在相关。仅在中年患者中，多变量调整后这种相关性仍然显著（比值比15.9，95%置信区间1.15 - 218.8）。总体而言，单变量分析中RSFV/VATV比值（r = 0.228，p = 0.002）和年龄（r = 0.316，p < 0.001）与CACS相关，但多变量分析中仅年龄相关。RSFV/VATV比值在中年患者中与CACS相关（r = 0.418，p < 0.001），多变量分析中也是如此。
我们证明RSFV/VATV可能是中年患者CAC的独立风险指标。
