Kurozumi Akira, Okada Yosuke, Arao Tadashi, Tanaka Yoshiya
The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Intern Med. 2016;55(21):3091-3095. doi: 10.2169/internalmedicine.55.6940. Epub 2016 Nov 1.
Objective Visceral fat obesity and metabolic syndrome correlate with atherosclerosis in part due to insulin resistance and various other factors. The aim of this study was to determine the relationship between vascular endothelial dysfunction and excess visceral adipose tissue (VAT) in Japanese patients with type 2 diabetes mellitus (T2DM). Methods In 71 T2DM patients, the reactive hyperemia index (RHI) was measured using an Endo-PAT 2000, and VAT and subcutaneous adipose tissue (SAT) were measured via CT. We also measured various metabolic markers, including high-molecular-weight adiponectin (HMW-AN). Results VAT correlated negatively with the natural logarithm of RHI (L_RHI), the primary endpoint (p=0.042, r=-0.242). L_RHI did not correlate with SAT, VAT/SAT, abdominal circumference, homeostasis model assessment for insulin resistance, urinary C-peptide reactivity, HMW-AN, or alanine amino transferase, the secondary endpoints. A linear multivariate analysis via the forced entry method using age, sex, VAT, and smoking history as independent variables and L_RHI as the dependent variable revealed a lack of any determinants of L_RHI. Conclusion Excess VAT worsens the vascular endothelial function, represented by RHI which was analyzed using Endo-PAT, in Japanese patients with T2DM.
目的 内脏脂肪型肥胖和代谢综合征与动脉粥样硬化相关，部分原因是胰岛素抵抗及其他多种因素。本研究旨在确定日本2型糖尿病（T2DM）患者血管内皮功能障碍与内脏脂肪组织（VAT）过多之间的关系。方法 对71例T2DM患者，使用Endo-PAT 2000测量反应性充血指数（RHI），通过CT测量VAT和皮下脂肪组织（SAT）。我们还测量了各种代谢指标，包括高分子量脂联素（HMW-AN）。结果 VAT与RHI的自然对数（L_RHI）呈负相关，L_RHI是主要终点指标（p = 0.042，r = -0.242）。L_RHI与SAT、VAT/SAT、腹围、胰岛素抵抗稳态模型评估、尿C肽反应性、HMW-AN或丙氨酸氨基转移酶（次要终点指标）均无相关性。以年龄、性别、VAT和吸烟史作为自变量，L_RHI作为因变量，通过强制进入法进行线性多变量分析，结果显示不存在L_RHI的任何决定因素。结论 在日本T2DM患者中，过多的VAT会使血管内皮功能恶化，这种功能以使用Endo-PAT分析的RHI来表示。
