Increased visceral adipose tissue mass is associated with increased C-reactive protein in patients with manifest vascular diseases
Increased visceral adipose tissue mass is associated with increased C-reactive protein in patients with manifest vascular diseases
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DOI：
10.1016/j.atherosclerosis.2010.04.029
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发表时间：
2010-09-01
期刊：
影响因子：
5.3
通讯作者：
Visseren, Frank L. J.
中科院分区：
文献类型：
--
作者：
Faber, Daniel R.;van der Graaf, Yolanda;Visseren, Frank L. J.
背景：肥胖与血管疾病和代谢并发症的发生有关。低度炎症是中心性肥胖的一个关键特征，其特征是血浆C反应蛋白(CRP)水平升高。方法：对2410例血管疾病患者(男1729例，女681例)皮下和内脏脂肪肿块进行超声检查。在空腹状态下测定代谢参数和C反应蛋白。通过线性回归分析来量化脂肪测量和血浆C反应蛋白之间的关系。C反应蛋白水平按对数转换。对年龄、吸烟、2型糖尿病、胰岛素抵抗(HOMA-IR)和用药情况进行了调整。结果：男性内脏脂肪分为四分位数(Q)，第一季度为3.2~7.8 cm，第四季度为11.019.8 cm，第二季度为2.76.0 cm，第四季度为9.017.4 cm。男性从第二季度的0.07(0.010.13)逐渐增加到第四季度的0.25(0.190.31)，女性从第二季度的0.17(0.070.26)逐渐增加到第四季度的0.42(0.320.52)，表明男性和女性第四季度的对数转换(LOG)C反应蛋白水平分别比第一季度高0.25和0.42 mg/L。按内脏脂肪标准差增加，LogCRP水平男性增加0.10 mg/L(0.070.12)，女性增加0.11(0.150.19)。同样，在单独的分析中，腰围和体重指数与四分位数的logCRP水平呈正相关，但相关性较弱(男性：腰围第四季度贝塔0.21(0.150.27)，身体质量指数第四季度贝塔0.23(0.170.30)；女性：腰围第四季度贝塔0.32(0.220.42)，第四季度贝塔0.32(0.220.42))。男性皮下脂肪与logCRP无相关性(第二季度至第四季度的β系数分别为-0.01(-0.07~-0.05)、-0.01(-0.07~-0.05)和0.05(-0.01~-0.11))。结论：内脏脂肪厚度是影响心血管疾病患者全身C反应蛋白浓度的最主要因素。(C)2010爱思唯尔爱尔兰有限公司。保留所有权利。
Background : Obesity is related to the development of vascular diseases and metabolic complications. Low grade inflammation is a key feature of central obesity, characterized by elevated plasma levels of C-reactive protein (CRP). We hypothesize that visceral adipose tissue contributes to systemic concentrations of CRP.Methods : In 2410 patients (1729 men and 681 women) with vascular diseases, subcutaneous and visceral fat masses were analyzed with ultrasonography. Metabolic parameters and CRP were measured in a fasting state. The association between fat measurements and plasma CRP was quantified using linear regression analysis. CRP levels were logarithmically transformed. Adjustments were made for age, smoking, type 2 diabetes mellitus, insulin resistance (HOMA-IR) and medication use.Results : Visceral fat was categorized into quartiles (Q) ranging from 3.2 to 7.8cm in Q1 (reference) to 11.019.8cm in Q4 in men and 2.76.0cm in Q1 (reference) to 9.017.4cm in Q4 in women. beta-coefficients gradually increased across the quartiles from 0.07 (0.010.13) in Q2 to 0.25 (0.190.31) in Q4 in men and 0.17 (0.070.26) in Q2 to 0.42 (0.320.52) in Q4 in women, indicating 0.25 and 0.42mg/l higher logarithmically transformed (log)CRP levels in Q4 compared to Q1 in respectively men and women. Per standard deviation increase of visceral fat, logCRP levels increased with 0.10mg/l (0.070.12) in men and with 0.11 (0.150.19) in women. Likewise, in separate analyses waist circumference and body mass index showed a positive, but weaker association with logCRP levels across quartiles (in men: beta 0.21 (0.150.27) in Q4 for waist circumference and beta 0.23 (0.170.30) in Q4 for body mass index; in women: beta 0.32 (0.220.42) in Q4 for waist circumference and beta 0.32 (0.220.42) in Q4 for body mass index). In men subcutaneous fat was not associated with logCRP (beta-coefficients relative to Q1: -0.01 (-0.07 to -0.05), -0.01 (-0.07 to -0.05) and 0.05 (-0.01 to -0.11) in Q2 to Q4 respectively).Conclusions : In conclusion, visceral fat thickness is the strongest contributor to the systemic CRP concentrations in patients with vascular diseases. (C) 2010 Elsevier Ireland Ltd. All rights reserved.