Coats Valérie, Després Jean-Pierre, Alméras Natalie, Martin Mickaël, Sin Don D, Rabasa-Lhoret Rémi, Larose Éric, Tan Wan C, Bourbeau Jean, Maltais François
Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Québec, QC, Canada,
University of British Columbia, Vancouver, BC, Canada.
Int J Chron Obstruct Pulmon Dis. 2018 Oct 15;13:3331-3340. doi: 10.2147/COPD.S168963. eCollection 2018.
Obesity/overweight is the most prevalent body composition abnormality in COPD. However, little is known about the impact of fat distribution on cardiometabolic health in COPD.
To study the associations between ectopic adiposity, cardiometabolic health, and COPD.
A total of 263 subjects (166 males; age=65±9 years) were randomly selected from the general population. Subjects were classified as non-COPD controls and COPD, according to the Global initiative for chronic Obstructive Lung Disease (GOLD) classification, and the presence of cardiometabolic comorbidities was recorded. Ectopic fat accumulation was documented from computed tomography measurements of visceral adipose tissue cross-sectional areas and muscle mean attenuation, assessed at L4-L5. Blood glucose, lipid, and adipokine profiles were also evaluated.
After correcting for age, sex, and tobacco exposure, visceral adipose tissue cross-sectional area was higher in GOLD 2+ compared to GOLD 1 individuals. Consistent with this, mean muscle tissue attenuation was lower in GOLD 2+ vs GOLD 1 and non-COPD controls (<0.001). In multiple regression models, visceral adipose tissue cross-sectional area was strongly associated with hypertension (<0.001) and diabetes (<0.001), while muscle attenuation was associated with coronary artery disease (<0.001). Blood glucose, lipid, and adipokine profiles were similar across groups with the exception of leptin level which was higher in GOLD 2+ subjects compared to GOLD 1 and controls.
GOLD 2+ COPD was associated with ectopic fat accumulation which modulated cardiometabolic health.
肥胖/超重是慢性阻塞性肺疾病（COPD）中最常见的身体成分异常。然而，关于脂肪分布对COPD患者心脏代谢健康的影响，我们知之甚少。
研究异位脂肪堆积、心脏代谢健康与COPD之间的关联。
从普通人群中随机选取263名受试者（166名男性；年龄=65±9岁）。根据慢性阻塞性肺疾病全球倡议（GOLD）分类，将受试者分为非COPD对照组和COPD组，并记录心脏代谢合并症的存在情况。通过计算机断层扫描测量L4-L5水平的内脏脂肪组织横截面积和肌肉平均衰减来记录异位脂肪堆积情况。还评估了血糖、血脂和脂肪因子谱。
在校正年龄、性别和烟草暴露因素后，GOLD 2+组的内脏脂肪组织横截面积高于GOLD 1组。与此一致的是，GOLD 2+组的平均肌肉组织衰减低于GOLD 1组和非COPD对照组（<0.0
