Obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries
Obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries
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DOI：
10.1016/s0735-1097(01)01212-8
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发表时间：
2001-05-01
影响因子：
24
通讯作者：
Lerman, A
中科院分区：
文献类型：
--
作者：
Al Suwaidi, J;Higano, ST;Lerman, A
美国心脏协会（AHA）最近将肥胖列为冠心病的可改变的危险因素。方法共有397例连续的正常或轻度冠状动脉病变的患者在血管造影时接受冠状动脉血管反应性评价，使用冠状动脉内腺苷，乙酰胆碱和硝酸甘油。根据体重指数（BMI）将患者分为三组：第1组，BMI 30的患者结果除超重但不肥胖的患者年龄明显大于正常体重的患者外，其他心血管危险因素在各组间无显著差异（第1组47 +/- 1岁，第2组53 +/- 1岁，第3组50 +/- 1岁，p < 0.001）。肥胖患者的冠状动脉血流量对乙酰胆碱的百分比变化（% CBF Ach）显著低于正常体重组（第1组为85.2 +/- 12.0%，第2组为63.7 +/- 10.0%，第3组为38.1 +/- 9.6%，p = 0.009）。通过多因素分析，超重（比值比，1.55; 95%置信区间，1.2-2.0）和肥胖（优势比，2.41; 95%置信区间，1.5-4.0）结论：研究表明，在正常或轻度冠状动脉病变患者中，肥胖与冠状动脉内皮功能障碍独立相关。动脉（美国科尔心脏病学杂志2001;37：1523-8）（C）2001年美国心脏病学会。
OBJECTIVES This study evaluates the impact of obesity on coronary endothelial function in patients with normal or mild coronary artery disease.BACKGROUND The American Heart Association (AHA) has recently classified obesity as a modifiable risk factor for coronary heart disease.METHODS A total of 397 consecutive patients with normal or mildly diseased coronary arteries at angiography underwent coronary vascular reactivity evaluation using intracoronary adenosine, acetylcholine and nitroglycerin. Patients were divided into three groups based on the body mass index (BMI): Group 1, patients with a BMI 30 (n = 131, obese).RESULTS There were no significant differences among the groups in regard to other cardiovascular risk factors, except that overweight but not obese patients were significantly older than normal-weight patients (47 +/- 1 years in Group 1, 53 +/- 1 years in Group 2 and 50 +/- 1 years in Group 3, p < 0.001). The percent change of coronary blood flow to acetylcholine (% CBF Ach) was significantly lower in the obese patients than in the normal-weight group (85.2 +/- 12.0% in Group 1, 63.7 +/- 10.0% in Group 2 and 38.1 +/- 9.6% in Group 3, p = 0.009). By multivariate analysis, overweight (odds ratio, 1.55; 95% confidence interval, 1.2-2.0) and obesity (odds ratio, 2.41; 95% confidence interval, 1.5-4.0) status were independently associated with impaired coronary endothelial function.CONCLUSIONS The study demonstrates that obesity is independently associated with coronary endothelial dysfunction in patients with normal or mildly diseased coronary arteries. (J Am Coll Cardiol 2001;37:1523-8) (C) 2001 by the American College of Cardiology.