Visceral adiposity and incident coronary heart disease in Japanese-American men - The 10-year follow-up results of the Seattle Japanese-American Community Diabetes Study
Visceral adiposity and incident coronary heart disease in Japanese-American men - The 10-year follow-up results of the Seattle Japanese-American Community Diabetes Study
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DOI：
10.2337/diacare.22.11.1808
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发表时间：
1999-11-01
期刊：
影响因子：
16.2
通讯作者：
Wahl, PW
中科院分区：
文献类型：
--
作者：
Fujimoto, WY;Bergstrom, RW;Wahl, PW
目的：确定冠心病(CHD)发病的危险因素。研究设计与方法：对175名无CHD的日裔美国男性进行长达10年的跟踪调查。基线变量为血压、体重、体重指数、计算机断层扫描的脂肪面积、皮褶厚度、腹围、血浆胰岛素、C-肽、胆固醇、低密度脂蛋白胆固醇、I-IDL胆固醇、HDL2胆固醇、HDL3胆固醇、甘油三酯、载脂蛋白AI和B，以及糖尿病和高血压的诊断。根据心电图和临床事件诊断冠心病。用Logistic回归估计优势比。结果：共发生冠心病50例。单因素Logistic回归分析显示，有意义的危险因素为腹内脂肪(P=0.0090)、空腹血糖(P=0.0002)、2 h血糖(P=0.0008)、空腹高密度脂蛋白胆固醇(P=0.0086)、空腹高密度脂蛋白胆固醇(P=0.030)、空腹高密度脂蛋白胆固醇(P=0.018)、空腹甘油三酯(P=0.013)、收缩压(P=0.0007)、舒张压(P=0.0002)、糖尿病(P=0.0002)。调整了BMI和年龄的多重Logistic回归模型显示，腹内脂肪是高密度脂蛋白胆固醇或甘油三酯影响的原因。在包括腹内脂肪的多元Logistic回归模型中，所有的收缩压和空腹血糖都是显著的。用舒张压代替收缩压，用2小时血糖或糖尿病状态代替空腹血糖，结果相似。结论内脏肥胖症、血压和血糖是该人群中糖尿病和非糖尿病日裔男性发生冠心病的重要独立危险因素。
OBJECTIVE - To identify risk factors for incident coronary: heart disease (CHD).RESEARCH DESIGN AND METHODS - A total of 175 Japanese-American men without CHD were followed for up to 10 years. Baseline variables were blood pressure, weight, BMI, fat areas by computed tomography, skinfold thicknesses, abdominal circumference, plasma insulin, C-peptide, cholesterol, LDL cholesterol, I-IDL cholesterol, HDL2 cholesterol, and HDL3 cholesterol, triglycerides, apoproteins AI and B, and diagnosis of diabetes and hypertension. CHD was diagnosed by electrocardiogram and clinical events. Logistic regression was used to estimate odds ratio.RESULTS - There were 50 incident cases of CHD. Using univariate logistic regression analysis, significant risk factors were intra-abdominal fat (P = 0.0090), fasting glucose (P = 0.0002), 2-h glucose (P = 0.0008), fasting HDL cholesterol (P = 0.0086), fasting HDL2 cholesterol (P = 0.030), fasting HDL3 cholesterol (P = 0.018), fasting triglycerides (P = 0.013), systolic (P = 0.0007) and diastolic blood pressure (P = 0.0002), and presence of diabetes (P = 0.0002). Multiple logistic regression models adjusted for BMI and age showed that intra-abdominar fat accounted for the effects of HDL cholesterol or triglycerides. In a multiple logistic regression model that included inh-a-abdominal fat, all systolic blood pressure and fasting glucose were significant. Substituting diastolic blood pressure for systolic blood pressure and 2-h glucose or diabetes status for fasting glucose produced similar results.CONCLUSIONS - Visceral adiposity blood pressure, and plasma glucose are important independent risk factors for incident CHD in this population of diabetic and nondiabetic Japanese-American men.