Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women
Impact of visceral fat on blood pressure and insulin sensitivity in hypertensive obese women
复制标题
DOI：
10.1038/oby.2002.164
复制
发表时间：
2002-12-01
期刊：
影响因子：
--
通讯作者：
Zanella, MT
中科院分区：
文献类型：
--
作者：
Faria, AN;Ribeiro, FF;Zanella, MT
目的：研究方法和步骤：我们研究了74名高血压女性（年龄49.8 ± 7.5岁，体重指数39.1 ± 5.5 kg/m2，腰臀比0.96 ± 0.08）。所有患者均接受24小时动态血压监测（24 h-ABPM）。腹部超声检查用于估计内脏脂肪（VF）的量。空腹取血测定血清瘦素和胰岛素。结果：64%的绝经妇女，腰臀比> 0.85，脂肪呈中心分布; VF与收缩期24小时ABPM值（r = 0.28，p = 0.01）和HOMA-r指数（r = 0.27; p = 0.01）相关。绝经后组（n = 48）的VF测量值（7.5 +/- 2.3 vs. 5.9 +/- 2.2 cm，p < 0.001）和收缩期24小时ABPM（133 ± 14.5 vs. 126 ± 9.8 mm Hg，p = 0.04）显著高于绝经前组（n = 26），但HOMA-r指数无显著差异。未观察到血压水平与HOMA-r指数、瘦素或胰岛素水平之间的相关性。在多元回归分析中，内脏脂肪，而不是年龄，体脂量，或HOMA-r指数，与24小时ABPM（p = 0.003）。讨论：在中心性肥胖高血压妇女，VF的积累，更经常绝经后，与较高水平的血压和胰岛素抵抗。VF导致高血压水平的机制似乎与瘦素或胰岛素水平无关。
Objective: The relationship among body fat distribution, blood pressure, serum leptin levels, and insulin resistance was investigated in hypertensive obese women with central distribution of fat.Research Methods and Procedures: We studied 74 hypertensive women (age, 49.8 +/- 7.5 years; body mass index, 39.1 +/- 5.5 kg/m(2); waist-to-hip ratio, 0.96 +/- 0.08). All patients were submitted to 24-hour blood pressure ambulatory monitoring (24h-ABPM). Abdominal ultrasonography was used to estimate the amount of visceral fat (VF). Fasting blood samples were obtained for serum leptin and insulin determinations. Insulin resistance was estimated by homeostasis model assessment insulin resistance index (HOMA-r index).Results: Sixty-four percent of the women were postmenopausal, and all patients showed central distribution of fat (waist-to-hip ratio > 0.85). The VF correlated with systolic 24h-ABPM values (r = 0.28, p = 0.01) and with HOMA-r index (r = 0.27; p = 0.01). VF measurement (7.5 +/- 2.3 vs. 5.9 +/- 2.2 cm, p < 0.001) and the systolic 24h-ABPM (133 ± 14.5 vs. 126 ± 9.8 mm Hg, p = 0.04), but not HOMA-r index, were significantly higher in the postmenopausal group (n = 48) than in the premenopausal group (n = 26). No correlations were observed between blood pressure levels and HOMA-r index, leptin, or insulin levels. In the multiple regression analysis, visceral fat, but not age, body fat mass, or HOMA-r index, correlated with the 24h-ABPM (p = 0.003).Discussion: In centrally obese hypertensive women, the accumulation of VF, more often after menopause, is associated with higher levels of blood pressure and insulin resistance. The mechanism through which VF contributes to higher blood pressure levels seems to be independent of leptin or insulin levels.