Visceral adiposity and the prevalence of hypertension in Japanese Americans
Visceral adiposity and the prevalence of hypertension in Japanese Americans
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DOI：
10.1161/01.cir.0000087597.59169.8d
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发表时间：
2003-10-07
期刊：
影响因子：
37.8
通讯作者：
Fujimoto, WY
中科院分区：
文献类型：
--
作者：
Hayashi, T;Boyko, EJ;Fujimoto, WY
背景-内脏肥胖通常被认为在包括高血压在内的代谢综合征中起关键作用。这项研究的目的是横断面评估内脏肥胖是否与高血压的患病率有关，独立于其他脂肪库和空腹血浆胰岛素。方法和结果-研究对象包括563名糖耐量正常或受损或糖尿病但在入院时未服用口服降糖药物或胰岛素的日裔美国人。变量包括隔夜禁食后和口服葡萄糖耐量试验期间测量的血糖和胰岛素，以及腹部、胸部和大腿脂肪区域的CT检查。总脂肪面积(TFA)计算为这些脂肪面积的总和。高血压的定义是：收缩压大于或等于140毫米汞柱，舒张压大于或等于90毫米汞柱，或服用降压药。腹内脂肪面积(IAFA)与高血压患病率高相关。在调整了年龄、性别、空腹胰岛素、2小时血糖的非线性转换和TFA后，IAFA调整高血压的优势比为1.68，1-SD增加(95%CI，1.20至2.37)。即使在调整了总皮下脂肪面积、腹部皮下脂肪面积、体重指数或腰围后，IAFA仍然是高血压患病率的重要预测因子，但在包含IAFA的模型中，区域或总体肥胖度与高血压患病率无关。结论：在日裔美国人中，内脏肥胖度越大，高血压患病率就越高，这与其他脂肪储备和空腹血浆胰岛素无关。
Background-Visceral adiposity is generally considered to play a key role in the metabolic syndrome, including hypertension. The purpose of this study was to evaluate cross-sectionally whether visceral adiposity is associated with prevalence of hypertension independent of other adipose depots and fasting plasma insulin.Methods and Results-Study subjects included 563 Japanese Americans with normal or impaired glucose tolerance or diabetes but not taking oral hypoglycemic medication or insulin at entry. Variables included plasma glucose and insulin measured after an overnight fast and during an oral glucose tolerance test, and abdominal, thoracic, and thigh fat areas by CT. Total fat area (TFA) was calculated as the sum of these fat areas. Hypertension was defined as having a systolic blood pressure greater than or equal to140 mm Hg, having a diastolic blood pressure greater than or equal to90 mm Hg, or taking antihypertensive medications. Intra-abdominal fat area (IAFA) was associated with a higher prevalence of hypertension. Adjusted odds ratio of hypertension by IAFA was 1.68 for a 1-SD increase (95% CI, 1.20 to 2.37) after adjusting for age, sex, fasting plasma insulin, a nonlinear transformation of 2-hour plasma glucose, and TFA. IAFA remained a significant predictor of prevalence of hypertension even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, body mass index, or waist circumference, but no measure of regional or total adiposity was associated with the odds of prevalence of hypertension in models that contained IAFA.Conclusions-Greater visceral adiposity increases the odds of hypertension in Japanese Americans independent of other adipose depots and fasting plasma insulin.