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|本期目录/Table of Contents|

腹型肥胖患者体脂分布与代谢综合征及冠状动脉病变的关系

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第1期
页码:
40-043,052
栏目:
临床研究
出版日期:
2017-10-10

文章信息/Info

Title:
Fat distribution in abdominal obesity and its relationship to metabolic syndrome and coronary artery disease
作者:
贺秀华1; 田 刚12
(1.许昌市中心医院心内科，河南 许昌 461000；2.西安交通大学第一附属医院心内科，陕西 西安 710061)
Author(s):
HE Xiu-hua1;  TIAN Gang2
(1.Department of Cardiology, Xuchang Central Hospital, Xuchang 461000, Henan, China; 2.Department of Cardiology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China)
关键词:
肥胖; 腹型; 体脂分布; 代谢综合征; 冠状动脉病变
Keywords:
abdominal obesity;  fat distribution;  metabolic syndrome;  coronary artery diseases
分类号:
R543.3
DOI:
-
文献标识码:
A
摘要:
目的 探讨腹型肥胖患者各部位脂肪分布与代谢综合征（MS）和冠状动脉病变（CAD）的关系。方法 57例腹型肥胖患者，采用GE64层螺旋CT评估腹部、心脏及冠脉周围脂肪分布情况，超声评估肾脏周围脂肪分布情况，同时测量血生化指标、体质量指数和腰臀比等。结果 ①MS组VAT、肾短轴脂肪面积及Gessini积分显著高于单纯肥胖组〔分别为(2290±601) cc vs.(3024±792) cc；(13.4±1.1) mm2 vs.(18.8±2.2) mm2；(20±3) vs.(46±6)；P<0.05，P<0.01〕；多因素Logistic回归分析显示VAT是MS的独立危险因素（OR=1.002，95%CI 1.000-1.003，P<0.05）；②Gessini评分>80分组WHR、MS异常代谢组分个数、糖尿病比例、CYS-C、EAT、冠脉周围脂肪厚度均显著高于Gessini评分40~80分组及Gessini评分<40分组〔分别为(1.10±0.01) vs.(0.96±0.01)、(0.96±0.01)；(4.38±0.38) vs.(3.35±0.27)、(2.71±0.27)；71% vs. 17%、6%；(1.33±0.21) mg/L vs.(1.03±0.07) mg/L、(0.86±0.04) mg/L；(217±58) cc vs.(201±18) cc、(129±18) cc；(17.0±1.2) mm vs.(14.3±0.6) mm、(10.4±0.6) mm；P<0.05，P<0.01〕。多因素逐步回归分析显示，MS异常代谢组分个数、CYS-C、冠脉周围脂肪厚度是影响冠脉病变程度的危险因素。结论 肥胖患者体内不同部位的脂肪沉积对其代谢、心血管疾病的作用具有差异性；在明显肥胖患者中，心脏及冠脉周围脂肪分布可能是更重要的心血管危险因子。
Abstract:
AIM To describe the characteristics of fat distribution in obesity and to explore its relationship to the occurrence and severity of metabolic disorder and coronary artery diseases. METHODS Fifty-seven patients (43 males and 14 females) with definite abdominal obesity, mean age of 52.44±11.47 yeas were included in this study. Fat accumulation in heart, aorta and abdominal viscera were quantified by 64-slice computer tomography. Peri-renal fat accumulation was measured by ultrasound. Traditional cardiovascular risk factors and metabolic risk factors were also examined. RESULTS VAT, peri-renal fat and Gessini score were significantly larger in patients with metabolic syndrome (MS) than those without ［(2290±601) cc versus.(3024±792) cc; (13.4±1.1) mm2 vs.(18.8±2.2) mm2; (20±3) vs.(46±6); P<0.05, P<0.01］. VAT was significantly associated with the pressence of MS by multivariate logistic regression (OR=1.002, 95%CI 1.000-1.003, P<0.05). WHR, number of MS components, diabetes mellitus, CYS-C, EAT and pericoronary adipose tissue in Gessini score>80 group were significantly higher than those in Gessini score 40~80 group and Gessini score<40 group ［(1.10±0.01) vs.(0.96±0.01), (0.96±0.01)；(4.38±0.38) vs.(3.35±0.27), (2.71±0.27); 71% vs. 17%, 6%; (1.33±0.21) mg/L vs.(1.03±0.07 ) mg/L, (0.86±0.04) mg/L; (217±58) cc vs.(201±18) cc, (129±18) cc; (17.0±1.2) mm vs.(14.3±0.6) mm, (10.4±0.6) mm; P<0.05, P<0.01］. Multivariate stepwise regression analysis showed a significant relationship between Gessini score and MS, pericoronary adipose tissue thickness and cystatin. CONCLUSION Varying locations of body fat distribution play different roles in obesity-related metabolic cardiovascular disease in abdominal obesity.

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备注/Memo

备注/Memo:
收稿日期：2017-01-24.基金项目：国家自然科学基金项目资助（30871042） 作者简介：贺秀华，主治医师，硕士 Email：hexiuhua0116@163.com
更新日期/Last Update: 1900-01-01