Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Department of Endocrinology and Metabolism, Gülhane Faculty of Medicine, Health Sciences University, Ankara, Turkey.
Metab Syndr Relat Disord. 2022 Jun;20(5):280-285. doi: 10.1089/met.2022.0009. Epub 2022 Apr 27.
The visceral adipose tissue excess in patients with diabetes mellitus (DM) is one of the mechanisms that plays role in the development of coronary atherosclerosis. Our study aimed to investigate the relationship between visceral adiposity index (VAI), an indicator of visceral adiposity, and Syntax score (SxS), a predictor of the severity of coronary artery disease (CAD), in patients with stable angina pectoris (SAP) and type 2 DM. A total of 253 patients with SAP and type 2 DM were included in this cross-sectional study. The patients were divided into three risk groups (low risk <22, 32 ≥ intermediate risk ≥22, high risk ≥33) according to the SxS based on invasive coronary angiography. Several adiposity indexes such as body mass index, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), and lipid accumulation product index (LAPI) were calculated using relevant formulas. In addition, VAI scores for each patient were calculated. There were no statistically significant differences between the low-, intermediate-, and high-risk groups for WHtR, BAI, and LAPI. WHR was found significantly lower in the low SxS group ( = 0.0038), and VAI was found significantly higher ( = 0.021) in the high SxS group. Besides, in multivariate logistic regression analysis, the VAI (odds ratio: 2.455; 95% confidence interval: 1.244-4.845; = 0.010) was an independent predictor of high SxS. In the receiver operating characteristic curve analysis, VAI with an optimal cutoff value of 2.048 predicted the severe coronary lesion with a sensitivity of 60.8% and a specificity of 61.5%. This study showed that VAI was an independent predictor in estimating CAD severity in patients with SAP and type 2 DM.
患有糖尿病（DM）的患者内脏脂肪组织过多是导致冠状动脉粥样硬化发展的机制之一。本研究旨在探讨内脏脂肪指数（VAI）与Syntax 评分（SxS）在稳定型心绞痛（SAP）和 2 型糖尿病患者中的关系。SxS 是一种预测冠心病严重程度的指标。本横断面研究共纳入 253 例 SAP 和 2 型糖尿病患者。根据有创冠状动脉造影，根据 SxS 将患者分为低危组（SxS<22）、中危组（SxS22~32）和高危组（SxS≥33）。采用相关公式计算体质量指数、腰臀比（WHR）、腰高比（WHtR）、体脂指数（BAI）和脂积聚产物指数（LAPI）等多个肥胖指数。此外，还计算了每位患者的 VAI 评分。在低危、中危和高危组之间，WHtR、BAI 和 LAPI 没有统计学差异。低 SxS 组的 WHR 明显较低（=0.0038），高 SxS 组的 VAI 明显较高（=0.021）。此外，在多元逻辑回归分析中，VAI（比值比：2.455；95%置信区间：1.244-4.845；=0.010）是高 SxS 的独立预测因子。在受试者工作特征曲线分析中，VAI 的最佳截断值为 2.048，预测严重冠状动脉病变的敏感性为 60.8%，特异性为 61.5%。本研究表明，VAI 是预测 SAP 和 2 型糖尿病患者 CAD 严重程度的独立预测因子。
