Maimaituxun Gulinu, Shimabukuro Michio, Salim Hotimah Masdan, Tabata Minoru, Yuji Daisuke, Morimoto Yoshihisa, Akasaka Takeshi, Matsuura Tomomi, Yagi Shusuke, Fukuda Daiju, Yamada Hirotsugu, Soeki Takeshi, Sugimoto Takaki, Tanaka Masashi, Takanashi Shuichiro, Sata Masataka
Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
PLoS One. 2017 Jun 8;12(6):e0177170. doi: 10.1371/journal.pone.0177170. eCollection 2017.
Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown.
Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG).
In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers were comparable between CABG and non-CABG groups. Multivariate logistic regression analysis showed that in men, CABG was determined by EATV Index and other ASCVD risk factors including hypertension, dyslipidemia, adiponectin, high sensitive C-reactive protein (hsCRP) and type 2 diabetes mellitus (Corrected R2 = 0.262, p < 0.0001), while in women, type 2 diabetes mellitus is a single strong predictor for CABG, excluding EATV Index (Corrected R2 = 0.266, p = 0.005).
Our study found that multiple risk factors, including epicardial adipose tissue volume and traditional ASCVD factors are determinants for CABG in men, but type 2 diabetes mellitus was the sole determinant in women. Gender-specific disparities in risk factors of CABG prompt us to evaluate new diagnostic and treatment strategies and to seek underlying mechanisms.
动脉粥样硬化性心血管疾病（ASCVD）的传统和非传统危险因素在男性和女性中存在差异。冠状动脉旁路移植术（CABG）患者中心外膜脂肪组织体积（EATV）的性别关联影响尚不清楚。
比较了172例行CABG或非冠状动脉瓣膜手术（非CABG）的患者（男性：115例；女性：57例）中EATV、腹部脂肪分布及其他传统ASCVD危险因素的性别关联影响。
在男性中，CABG组的EATV、EATV指数（EATV/体表面积）以及肥胖标志物如体重指数、腰围和内脏脂肪面积均高于非CABG组。传统ASCVD危险因素在CABG组中也很普遍。在女性中，CABG组的EATV和EATV指数较高，但CABG组和非CABG组之间的其他肥胖标志物相当。多因素逻辑回归分析显示，在男性中，CABG由EATV指数和其他ASCVD危险因素决定，包括高血压、血脂异常、脂联素、高敏C反应蛋白（hsCRP）和2型糖尿病（校正R2 = 0.262，p < 0.0001），而在女性中，2型糖尿病是CABG的单一强预测因素，不包括EATV指数（校正R2 = 0.266，p = 0.005）。
我们的研究发现，包括心外膜脂肪组织体积和传统ASCVD因素在内的多种危险因素是男性CABG的决定因素，但2型糖尿病是女性的唯一决定因素。CABG危险因素的性别特异性差异促使我们评估新的诊断和治疗策略，并寻找潜在机制。
