Apoloni Rafael Correa, Zerati Antonio Eduardo, Wolosker Nelson, Saes Glauco Fernandes, Wolosker Marina, Curado Taina, Puech-Leão Pedro, De Luccia Nelson
Department of Vascular Surgery, Hospital das Clinicas University of Sao Paulo, Sao Paulo, SP, Brazil.
Department of Vascular Surgery, Hospital das Clinicas University of Sao Paulo, Sao Paulo, SP, Brazil.
Ann Vasc Surg. 2019 Jan;54:176-184. doi: 10.1016/j.avsg.2018.06.016. Epub 2018 Aug 10.
Atherosclerosis and abdominal aortic aneurysms (AAAs) have several similar risk factors but different pathogenesis. Inflammation of the arteries is common to both. Central obesity can act as an endocrine organ through the secretion of inflammatory cytokines, and the perivascular fat has a local effect that could contribute to diseases of the abdominal aorta. Although the relation between central obesity and atherosclerosis occlusive arterial disease has been demonstrated, the correlation with AAA has conflicting results. The aim of this study was to analyze the correlation between central obesity and the presence of abdominal aortic diseases using computed tomography.
Six hundred thirty-nine consecutive patients classified into 3 groups (AAA, aortic atherosclerotic occlusive disease (AAOD), and without aortic disease [control group]) who underwent computed tomography had the aorta diameter, the visceral fat area (VFA), and the subcutaneous fat area (SFA) measured at the level of third and fourth lumbar vertebrae.
VFA showed no difference between the groups. SFA was lower in atherosclerotic group (AAOD) than control (P < 0.01 in general and P < 0.04 in male). In AAA group, we found in men that the first tertile of aorta diameter had higher VFA than third tertile (P = 0.02).
There was no difference in VFA between patients in AAA, AAOD, and without aortic disease groups. In men with aneurysm, there was an inverse relationship between VFA and aortic diameter. In AAOD, visceral to subcutaneous ratio is higher due to lower SFA.
动脉粥样硬化和腹主动脉瘤（AAA）有几个相似的风险因素，但发病机制不同。动脉炎症在两者中都很常见。中心性肥胖可通过分泌炎性细胞因子发挥内分泌器官的作用，血管周围脂肪具有局部作用，可能导致腹主动脉疾病。虽然中心性肥胖与动脉粥样硬化性闭塞性动脉疾病之间的关系已得到证实，但与AAA的相关性结果却相互矛盾。本研究的目的是使用计算机断层扫描分析中心性肥胖与腹主动脉疾病存在之间的相关性。
对639例连续接受计算机断层扫描的患者进行分组（AAA组、主动脉粥样硬化闭塞性疾病（AAOD）组和无主动脉疾病[对照组]），测量第三和第四腰椎水平的主动脉直径、内脏脂肪面积（VFA）和皮下脂肪面积（SFA）。
各组间VFA无差异。动脉粥样硬化组（AAOD）的SFA低于对照组（总体P < 0.01，男性P < 0.04）。在AAA组中，我们发现男性中主动脉直径处于第一三分位数的患者VFA高于第三三分位数（P = 0.02）。
AAA组、AAOD组和无主动脉疾病组患者的VFA无差异。在患有动脉瘤的男性中，VFA与主动脉直径呈负相关。在AAOD组中，由于SFA较低，内脏与皮下脂肪比例较高。
