脂肪分布对中国中年成年人亚临床冠状动脉粥样硬化的影响。
The impact of fat distribution on subclinical coronary atherosclerosis in middle-aged Chinese adults.
作者信息
Ding Lin, Peng Kui, Lin Lin, Li Mian, Wang Tiange, Dai Meng, Zhao Zhiyun, Xu Min, Lu Jieli, Chen Yuhong, Wang Weiqing, Bi Yufang, Xu Yu, Ning Guang
机构信息
State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai, China; Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, and Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai, China; Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
出版信息
Int J Cardiol. 2017 May 15;235:118-123. doi: 10.1016/j.ijcard.2017.02.082. Epub 2017 Feb 22.
BACKGROUND
The relationship between obesity and cardiovascular disease (CVD) depends not only on the amount of body fat but also on its distribution, which has not been fully investigated in Chinese populations. We aimed to compare measures of fat accumulation in associations with subclinical coronary atherosclerosis in middle-aged Chinese adults.
METHODS
A total of 548 participants aged 40-60years without previous history or clinical symptoms of CVD were randomly selected to undergo abdominal computed tomography (CT) scanning and coronary CT angiography for the evaluation of subcutaneous and visceral fat accumulation and coronary atherosclerosis, respectively. γ-glutamyltranspeptidase (GGT) was used as a surrogate indicator of liver fat accumulation.
RESULTS
Measures of obesity such as body-mass index (BMI), waist circumference, visceral fat areas, and GGT levels, but not subcutaneous fat areas increased substantially across groups of participants without coronary stenosis, with <50% stenosis, and with significant (≥50%) stenosis after adjustment for age and sex. The multivariable multinomial logistic regression analysis showed that most obesity indicators such as BMI, waist circumference, visceral fat areas, and GGT levels were significantly associated with risks of having <50% coronary stenosis after adjustment for conventional cardiovascular risk factors. However, only GGT levels were significantly associated with risks of having significant (≥50%) coronary stenosis after adjustment. In addition, no significant associations were found between measures of fat accumulation and coronary calcification.
CONCLUSIONS
Liver fat accumulation might be more important in the association with subclinical coronary atherosclerosis compared with general and abdominal fat accumulation.
背景
肥胖与心血管疾病（CVD）之间的关系不仅取决于体脂量，还取决于其分布情况，而在中国人群中尚未对此进行充分研究。我们旨在比较中国中年成年人脂肪堆积指标与亚临床冠状动脉粥样硬化之间的关联。
方法
总共随机选取了548名年龄在40至60岁之间、无CVD既往史或临床症状的参与者，分别进行腹部计算机断层扫描（CT）和冠状动脉CT血管造影，以评估皮下和内脏脂肪堆积以及冠状动脉粥样硬化情况。γ-谷氨酰转肽酶（GGT）用作肝脏脂肪堆积的替代指标。
结果
在调整年龄和性别后，体重指数（BMI）、腰围、内脏脂肪面积和GGT水平等肥胖指标在无冠状动脉狭窄、狭窄<50%以及狭窄显著（≥50%）的参与者组中均有大幅增加，但皮下脂肪面积未增加。多变量多项逻辑回归分析显示，在调整传统心血管危险因素后，大多数肥胖指标如BMI、腰围、内脏脂肪面积和GGT水平与冠状动脉狭窄<50%的风险显著相关。然而，调整后只有GGT水平与冠状动脉狭窄显著（≥50%）的风险显著相关。此外，未发现脂肪堆积指标与冠状动脉钙化之间存在显著关联。
结论
与全身和腹部脂肪堆积相比，肝脏脂肪堆积在与亚临床冠状动脉粥样硬化的关联中可能更为重要。
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