Kortelainen M L
Department of Forensic Medicine, University of Oulu, Finland.
Int J Obes Relat Metab Disord. 1996 Mar;20(3):245-52.
To determine the relationship between cardiovascular status and body fat tissue distribution in men without any premortem clinical evidence of cardiovascular disease.
30 forensic autopsy cases which consisted of sudden deaths resulting from accidental causes, suicides or homicides or from unexpected natural causes.
Body height and weight, the circumferences of the waist and hip and the thicknesses of the subscapular and abdominal subcutaneous fat were measured, and Body Mass Index (BMI) and Waist-to-Hip ratio (WHR) were calculated. Perirenal, omental and mesenterial fat deposits were weighed and supraclavicular-pericarotid and perirenal-periadrenal fat was excised and serial samples analyzed for brown adipose tissue (BAT) by computerized image analysis. The heart weight was indexed for height. The degree of coronary narrowing was determined in each artery, and myocardial collagen volume fraction and myocyte cross-sectional area were measured.
There were significantly positive correlations between age and the degree of coronary arteriosclerosis and heart weight/height. After adjusting for age, BMI and waist circumference had a significant positive correlation with all the cardiac parameters. The degree of coronary narrowing and heart weight/height were related to tertiles of BMI and waist circumstance. The age-adjusted correlations between the subscapular fat thickness and cardiac parameters were significant and positive, and perirenal fat weight also had a significantly positive association with all the cardiac parameters. BAT decreased with age and when adjusted for age, the cervical BAT percentage had a significant negative correlation with waist circumference and WHR, and a significant negative correlation was also found between cervical BAT and the degree of coronary arteriosclerosis and between perirenal BAT and heart weight/height.
The results suggest that body fatness is associated with coronary and myocardial pathology in men without any clinical evidence of cardiovascular disease. An abdominal accumulation of fat seems to be connected with both the severity of coronary lesions and myocardial hypertrophy in men, in whom there is also a connection between abdominal obesity and a relative scarcity of BAT. Future investigations will require more detailed analyses of the extent and ultrastructural of coronary artery lesions in order to obtain more specific information on the relationship of body fat distribution to the early asymptomatic phase of coronary disease in younger individuals.
确定无心血管疾病生前临床证据的男性心血管状况与体脂组织分布之间的关系。
30例法医尸检病例，包括因意外、自杀、他杀或意外自然原因导致的猝死。
测量身高、体重、腰围和臀围以及肩胛下和腹部皮下脂肪厚度，并计算体重指数（BMI）和腰臀比（WHR）。称量肾周、网膜和肠系膜脂肪沉积量，切除锁骨上-颈动脉和肾周-肾上腺脂肪，通过计算机图像分析对棕色脂肪组织（BAT）的系列样本进行分析。计算心脏重量与身高的比值。确定每条动脉的冠状动脉狭窄程度，测量心肌胶原体积分数和心肌细胞横截面积。
年龄与冠状动脉粥样硬化程度以及心脏重量/身高之间存在显著正相关。在调整年龄后，BMI和腰围与所有心脏参数均呈显著正相关。冠状动脉狭窄程度和心脏重量/身高与BMI和腰围的三分位数相关。调整年龄后，肩胛下脂肪厚度与心脏参数之间的相关性显著为正，肾周脂肪重量与所有心脏参数也呈显著正相关。BAT随年龄增长而减少，调整年龄后，颈部BAT百分比与腰围和WHR呈显著负相关，颈部BAT与冠状动脉粥样硬化程度之间以及肾周BAT与心脏重量/身高之间也存在显著负相关。
结果表明，在无心血管疾病临床证据的男性中，肥胖与冠状动脉和心肌病变有关。男性腹部脂肪堆积似乎与冠状动脉病变的严重程度和心肌肥大均有关，其中腹部肥胖与BAT相对缺乏之间也存在关联。未来的研究需要对冠状动脉病变的范围和超微结构进行更详细的分析，以便获得关于体脂分布与年轻个体冠状动脉疾病早期无症状阶段关系的更具体信息。
