Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans
Visceral adiposity is an independent predictor of incident hypertension in Japanese Americans
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DOI：
10.7326/0003-4819-140-12-200406150-00008
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发表时间：
2004-06-15
影响因子：
39.2
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：内脏脂肪通常被认为在代谢综合征中发挥关键作用。目的：检查直接测量的内脏脂肪与高血压风险之间的关系，独立于其他脂肪库和空腹血浆胰岛素水平。设计：基于社区的前瞻性队列研究，随访 10 至 11 年。地点：华盛顿州金县。参与者：300 名收缩压低于140 毫米汞柱且舒张压低于 90 毫米汞柱，且在研究开始时未服用抗高血压药物、口服降血糖药物或胰岛素。测量：使用计算机断层扫描测量腹部、胸部和大腿脂肪面积。总皮下脂肪面积计算为这些脂肪面积的总和，不包括腹内脂肪面积。随访期间高血压的定义为收缩压≥140mmHg、舒张压≥90mmHg或正在服用抗高血压药物。 结果：随访期间共发生高血压病例92例。腹内脂肪区域与高血压风险增加相关。调整年龄、性别、空腹血浆胰岛素水平、2 小时血浆后，与四分位数 1 相比，腹内脂肪面积四分位数（1 = 最低；4 = 最高）的高血压多重调整比值比，第 3 四分位数为 5.07（95% CI，1.75 至 14.73），第 4 四分位数为 3.48（CI，1.01 至 11.99）血糖水平、体重指数、收缩压、饮酒量、吸烟状况和运动能量消耗（二次趋势 P = 0.003）。即使在调整总皮下脂肪面积、腹部皮下脂肪面积或腰围后，腹内脂肪面积仍然是高血压的重要危险因素；然而，在包含腹内脂肪区域的模型中，这些脂肪区域的测量与高血压风险无关。局限性：尚不清楚这些结果是否适用于其他种族群体。结论：内脏肥胖程度较高会增加日裔美国人患高血压的风险。
Background: Visceral adiposity is generally considered to play a key role in the metabolic syndrome.Objective: To examine the relationship between directly measured visceral adiposity and the risk for incident hypertension, independent of other adipose depots and fasting plasma insulin levels.Design: Community-based prospective cohort study with 10- to 11-year follow-up.Setting: King County, Washington.Participants: 300 Japanese Americans with a systolic blood pressure less than 140 mm Hg and a diastolic blood pressure less than 90 mm Hg who were not taking anti hypertensive medications, oral hypoglycemic medications, or insulin at study entry.Measurements: Abdominal, thoracic, and thigh fat areas were measured by using computed tomography. Total subcutaneous fat area was calculated as the sum of these fat areas excluding the intra-abdominal fat area. Hypertension during follow-up was defined as having a systolic blood pressure of 140 mm Hg or greater, having a diastolic blood pressure of 90 mm Hg or greater, or taking anti hypertensive medications.Results: There were 92 incident cases of hypertension during the follow-up period. The intra-abdominal fat area was associated with an increased risk for hypertension. Multiple-adjusted odds ratios of hypertension for quartiles of intra-abdominal fat area (1 = lowest; 4 = highest) were 5.07 (95% CI, 1.75 to 14.73) for quartile 3 and 3.48 (CI, 1.01 to 11.99) for quartile 4 compared with quartile 1 after adjustment for age, sex, fasting plasma insulin level, 2-hour plasma glucose level, body mass index, systolic blood pressure, alcohol consumption, smoking status, and energy expenditure through exercise (P = 0.003 for quadratic trend). The intra-abdominal fat area remained a significant risk factor for hypertension, even after adjustment for total subcutaneous fat area, abdominal subcutaneous fat area, or waist circumference; however, no measure of these fat areas was associated with risk for hypertension in models that contained the intra-abdominal fat area. Limitations: It is not known whether these results pertain to other ethnic groups.Conclusions: Greater visceral adiposity increases the risk for hypertension in Japanese Americans.