관상동맥경화증 환자에서 체지방분포와 항산화체계의 변화

Abstract

BACKGROUND: Changes in body fat distribution and antioxidant status can be shown in patients with coronary heart disease (CHD) and these changes may be more pronounced in CHD patients with than those without diabetes. This study was undertaken to determine the discrimination of body fat distribution, hormones and antioxidants among healthy male and CHD male patients with and without diabetes. METHODS: An oral glucose tolerance test was performed in 64 healthy males and 56 CHD male patients. CHD group was subdivided into patients with and without diabetes. Adipose tissue and muscle areas were calculated from computed tomography scans made at four body levels, L1, L4 and mid portion of thigh and calf. Fasting serum levels of lipids, hormones and antioxidants and plasma level of homocysteine were determined. RESULTS: 28% of healthy males, 33% of CHD patients without diabetes and 15% of CHD patients with diabetes were current smokers. 56% of healthy males, 30% of CHD patients without diabetes and 46% of CHD patients with diabetes supplemented their diet with synthetic vitamin preparation. There were no differences among groups in means of age, body mass index and blood pressure. While CHD patients without diabetes showed an increase in visceral fat area at only L1 level, CHD patients with diabetes showed an increase at both L1 and L4 levels, compared with healthy males. CHD patients with diabetes showed the lowest mean value of HDL-cholesterol and testosterone. The mean response areaof insulin and C-peptide during OGTT was higher in CHD patients without diabetes than healthy males. CHD patients with and without diabetes showed higher plasma level of homocysteine and lower serum levels of IGF-1, superoxide dismutase (SOD) and beta-carotene, compared with healthy males. Serum levels of cryptoxanthin and lycopene were lower in CHD patients with diabetes than healthy males. CONCLUSION: Visceral fat accumulation, an increase in insuline and homocysteine levels and a decrease in IGF-1, SOD and beta-carotene levels in CHD patients indicate a difference in body fat distribution, hormones and antioxidant systems between CHD patients and healthy males. In addition, a further increase in visceral fat and a decrease in the serum levels of HDL-cholesterol, testosterone and carotenoids in CHD patients with diabetes show the increased risk in the simultaneous presence of CHD and diabetes. Thus, the lifestyle modification of these CHD patients such as quitting smoking, reducing abdominal fat and taking antioxidant-rich foods is recommended.