관상동맥경화증의 정도와 내장지방비만과의 관계

Abstract

Background : The visceral fat obesity is known to be associated with coronary artery disease. We investigated the relation between visceral fat obesity and the severity of coronary artery disease by angiography. Methods : The coronary artery disease (CAD) group included 54 angina patients (43 men and 11 women) with angiographically demonstrated coronary artery disease. The control group included angiographically normal 28 controls (15 men and 13 women). The subjects with hypertension, non-insulin dependent diabetes mellitus (NIDDM) and taking any medication known to affect the insulin sensitivity were excluded. We measured the visceral fat area, abdominal subcutaneous fat area, thigh muscle area and the thigh fat area with computed tomography (CT) in both groups. We measured the plasma lipid profile, fasting plasma insulin and glucose level in both groups. Results : There were no differences in the age, sex ratio and body mass index (BMI between both groups. Total cholesterol and triglyceride increased in CAD group significant) ) HDL cholesterol decreased in CAD Y (p X0.05, p X0,001). The group. But there was no statistical significance (p=0.056). The fasting insulin increased in CAD group significantly (p <0.00I). There were significant differences between CAD grow and the control group in the visceral fat area (117.834,4 cm´vs. 85.517.6 cmZ p 022.3 cm2vs. 65.812.9 CM2, P<0.001), visceral fat to abdominal subcutaneous fat area ratio (VStratio : 0. area (50. 810.31 vs. 0.510.15, P<0.001) and the visceral at to thigh fat area ratio (VSFTF ratio : 2.721.24 vs. 1. 340.35, p<0.001). In the male subgroup (CAD : 43, control : 15), triglyceride and fasting insulin increased in CAD group significantly (p <0.001). The visceral fat area, VS ratio, and VSFTF ratio increased in CAD group significantly (P<0.001) The thigh fat area decreased in CAD group significantly (P <0.001). In the female subgroup (CAD : 11, control : 13), fasting insulin and visceral fat area increased in CAD group significantly <0.001, p <0.05). Multiple logistic regression analysis revealed that VSFTF ratio, fasting insulin antth HDL cholesterol were independent associated factors of coronary artery disease. In comparison with normal control, one-vessel disease and multi-vessel disease (two vessel and three vessel), there were significant differences between groups in fasting insulin, triglyceride, visceral fat area, thigh fat area, VS ratio, VSFTF ratio. In Turkey´s HSD Post Hoc test, however, there were no significant differences between one-vessel disease and multi-vessel disease. Conclusion : We observed significant increases in the visceral fat area, VS ratio and VSFTF ratio and decrease in thigh fat area in angiographically demonstrated CAD group compared with age, BMI matched angiographically normal control. But we did not observed any relation between the visceral fat area and the severity of coronary disease by angiography.