Abstract

Aim. To study visceral adipose tissue (VAT) content in patients with coronary artery disease (CAD) using the bioimpedance analysis, to identify metabolic disorders associated with visceral obesity, and to determine the role of individual risk factors in the formation of coronary artery lesions using modern statistical methods.Material and methods. A total of 152 patients were examined (women, 66; men, 86). The median age of patients was 63 [55;69] years. This observational study assessed anthropometric parameters, such as height, weight, body mass index, waist circumference, whole-body fat percentage, and specifically VAT mass, as well as the relationship of these parameters with blood levels of triglycerides, high-density lipoprotein cholesterol (HDL-C) and glucose. Height was measured using a metal height meter RM-1 “Diakoms”. Weight, body mass index, wholebody fat percentage, and VAT mass were measured using the Omron BF-508 body composition monitor (Omron, Japan). Epicardial adipose tissue (EAT) thickness was assessed using two-dimensional echocardiography on a Philips Sonos 5500 ultrasound system (Germany).Results. Bioimpedance analysis revealed a higher VAT content in patients with CAD compared with those without CAD (14 [11;18]% vs 13 [10;14,5]%, respectively (p=0,025)). During the ROC analysis, cut-off values for VAT ≥15% and EAT ≥7,5 mm were identified, associated with a higher risk of CAD. In multivariate analysis, only HDL-C levels were significantly associated with CAD, while at the same time, univariate analysis demonstrated the significance of VAT and EAT in predicting CAD.Conclusion. The results showed that an increased VAT content and low HDL-C level is associated with the presence of CAD.

Highlights

  • Only high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with coronary artery disease (CAD), while at the same time, univariate analysis demonstrated the significance of visceral adipose tissue (VAT) and Epicardial adipose tissue (EAT) in predicting CAD

  • The results showed that an increased VAT content and low HDL-C level is associated with the presence of CAD

  • J Am Coll Cardiol. 2010;55:1283-99. doi:10.1016/j. jacc.2010.01.008

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Summary

ОРИГИНАЛЬНЫЕ СТАТЬИ

В исследовании, включавшем американских мужчин японского происхождения, было установлено, что у тех, у которых в дальнейшем при наблюдении в течение 10 лет развилась ишемическая болезнь сердца (ИБС), были более высокие уровни содержания ВЖТ, и возникновение заболевания не зависело от величины индекса массы тела (ИМТ) [11]. Критерии включения: мужчины и женщины в возрасте 45-75 лет с повышенным ИМТ с ССЗ (хроническая ИБС, АГ, предсердные пароксизмальные нарушения ритма сердца (НРС)). В ходе наблюдательного исследования оценивались антропометрические параметры роста, веса, ИМТ, процент жировой ткани и отдельно процент ВЖТ, а также взаимосвязь этих параметров с содержанием в крови ХС-ЛВП, ТГ и глюкозы. Сокращения: АГ — артериальная гипертония, ВЖТ — висцеральная жировая ткань, ИБС — ишемическая болезнь сердца, ИМТ — индекс массы тела, НРС — нарушения ритма сердца, ЭЖТ — эпикардиальная жировая ткань. Таблица 5 Критерии высокого риска наличия ИБС, полученные с использованием ROC-анализа среди всех обследованных больных

Критерии наличия диагноза ИБС Пороговые значения Чувствительность Специфичность
Findings
ИБС присутствует
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