Department of Medicine, Mackay Medical College, Taipei, Taiwan.
Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
PLoS One. 2018 Nov 20;13(11):e0207284. doi: 10.1371/journal.pone.0207284. eCollection 2018.
Visceral adiposity is associated with cardiovascular disease, an association that may be mediated in part by inflammation. We hypothesized that regional measures of visceral adiposity would associate with commonly obtained clinical measures of immune status. We consecutively studied 3,291 subjects (mean age, 49.8±9.8 years) who underwent an annual cardiovascular risk survey. Peri-cardial (PCF) and thoracic peri-aortic adipose tissue (TAT) volumes were determined by dedicated computed tomography (CT) software (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Hepatic steatosis was assessed by abdominal ultrasonography. We explored cross-sectional associations between visceral fat measures and high-sensitivity C-reactive protein (hs-CRP), leukocyte counts, and the neutrophil-to-lymphocyte ration (NLR). Among 3,291 study participants, we observed positive linear associations between PCF and TAT, higher degree of hepatic steatosis and hs-CRP, various leukocyte counts, either total and its differential counts, and NLR (all trend p<0.001). Multi-variate linear and logistic regression models showed independent associations between PCF/TAT (ß-Coef: 0.14/0.16, both p<0.05) and total WBC counts, with only TAT further demonstrated significant relations with neutrophil counts and NLR (both p<0.05) and independently identified abnormally high WBC and NLR (Odds ratio: 1.18 & 1.21, both p<0.05). C-statistics showed significant incremental model prediction for abnormally high WBC and NLR (both ΔAUROC<0.05) when TAT was superimposed on traditional cardiovascular risks and biochemical information. Greater visceral adiposity burden and hepatic steatosis may be associated with higher circulating leukocyte counts and markers for atherosclerosis, with more pronounced influences for peri-aortic adiposity. Our data suggested the differential biological impacts for region-specific visceral adiposity.
内脏脂肪与心血管疾病相关，这种关联部分可能是通过炎症介导的。我们假设，内脏脂肪的区域测量值将与通常获得的免疫状态的临床测量值相关。我们连续研究了 3291 名（平均年龄 49.8±9.8 岁）接受年度心血管风险调查的受试者。通过专用的计算机断层扫描（CT）软件（Aquarius 3D 工作站，TeraRecon，加利福尼亚州圣马特奥）确定心外膜（PCF）和胸主动脉周围脂肪组织（TAT）的体积。通过腹部超声评估肝脂肪变性。我们探讨了内脏脂肪测量值与高敏 C 反应蛋白（hs-CRP）、白细胞计数和中性粒细胞与淋巴细胞比值（NLR）之间的横断面相关性。在 3291 名研究参与者中，我们观察到 PCF 和 TAT 之间存在正线性关联，肝脂肪变性程度越高、hs-CRP、各种白细胞计数（包括总数及其分类计数）和 NLR 越高（所有趋势 p<0.001）。多元线性和逻辑回归模型显示 PCF/TAT 与总白细胞计数之间存在独立关联（β-Coef：0.14/0.16，均 p<0.05），仅 TAT 进一步显示与中性粒细胞计数和 NLR 之间存在显著关系（均 p<0.05），并独立确定异常高的白细胞和 NLR（优势比：1.18 和 1.21，均 p<0.05）。C 统计显示，当 TAT 叠加在传统心血管风险和生化信息上时，异常高的白细胞和 NLR 的模型预测有显著的增量（两者ΔAUROC<0.05）。内脏脂肪负担和肝脂肪变性越大，可能与循环白细胞计数和动脉粥样硬化标志物水平越高相关，而主动脉周围脂肪的影响更为明显。我们的数据表明，特定区域的内脏脂肪具有不同的生物学影响。
