总体肥胖而非体重指数与血脂及促凝血因子的关联。

Association of overall adiposity rather than body mass index with lipids and procoagulant factors.

作者信息

De Lorenzo F, Mukherjee M, Kadziola Z, Suleiman S, Kakkar V V

机构信息

Thrombosis Research Institute, London, UK.

出版信息

Thromb Haemost. 1998 Oct;80(4):603-6.

PMID:9798978

Abstract

The association between obesity and risk of coronary artery disease is well established. The distribution of body fat was shown to be related to serum lipids and lipoproteins in a group of healthy men, but the association between body fat and haemostatic factors is less clear. The aim of the present study was to determine the association of overall adiposity (OVRAD, percent total fat mass contributing to body weight) and body mass index (BMI, weight/height2) with lipids and haemostatic factors in order to evaluate which of these was more associated with circulating procoagulant factors. The total fat mass was estimated by dual-energy X-ray absorptiometry (DEXA) and OVRAD computed for 28 male and 36 healthy female subjects, whose median age were 44.2 years and 48.4 years respectively. In addition, the BMI was computed for each of them from their weight and height measurements. Fasting samples were analysed for serum lipids (total, HDL- and LDL-cholesterol and triglyceride) and plasma fibrinogen, factor VII coagulant (FVII:C) activity, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) activities. The men and women had similar median BMI (23.9 kg/m2 and 23.1 kg/m2 respectively), but the median fat mass of women (19.6 kg) was higher than that of men (16.9 kg). Age, BMI and OVRAD exhibited statistically significant correlations with lipids and haemostatic factors in both men and women. However, when BMI was adjusted for age and OVRAD, the statistically significant associations were no longer apparent in men or women. In contrast, OVRAD adjusted for age and BMI still exhibited statistically significant associations with FVII:C activity (R = 0.38, p = 0.05), triglyceride (R = 0.51, p = 0.008), LDL-cholesterol (R = 0.45, p = 0.02) and HDL/Total cholesterol ratio (R = -0.63, p <0.001). It is concluded that OVRAD, a fat mass-based index, rather than BMI, a weight-height based index, is better associated with circulating coronary risk factors.

摘要

肥胖与冠状动脉疾病风险之间的关联已得到充分证实。在一组健康男性中，身体脂肪分布与血脂及脂蛋白有关，但身体脂肪与止血因子之间的关联尚不清楚。本研究的目的是确定总体肥胖程度（OVRAD，即占体重的总脂肪量百分比）和体重指数（BMI，体重/身高²）与血脂及止血因子之间的关联，以便评估哪一个与循环促凝血因子的关联更强。通过双能X射线吸收法（DEXA）估算总脂肪量，并计算28名男性和36名健康女性受试者的OVRAD，他们的年龄中位数分别为44.2岁和48.4岁。此外，根据他们的体重和身高测量值计算每个人的BMI。对空腹样本进行血脂（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯）以及血浆纤维蛋白原、凝血因子VII活性（FVII:C）、组织型纤溶酶原激活剂（t-PA）和纤溶酶原激活剂抑制剂-1（PAI-1）活性分析。男性和女性的BMI中位数相似（分别为23.9 kg/m²和23.1 kg/m²），但女性的脂肪量中位数（19.6 kg）高于男性（16.9 kg）。年龄、BMI和OVRAD在男性和女性中均与血脂及止血因子呈现出统计学上的显著相关性。然而，当对BMI进行年龄和OVRAD校正后，男性或女性中具有统计学意义的关联不再明显。相比之下，经年龄和BMI校正后的OVRAD仍与FVII:C活性（R = 0.38，p = 0.05）、甘油三酯（R = 0.51，p = 0.008）、低密度脂蛋白胆固醇（R = 0.45，p = 0.02）和高密度脂蛋白/总胆固醇比值（R = -0.63，p <0.001）呈现出统计学上的显著关联。研究得出结论，基于脂肪量的指标OVRAD，而非基于体重身高的指标BMI，与循环冠状动脉风险因子的关联更强。