Obesity accelerates the progression of coronary atherosclerosis in young men
Obesity accelerates the progression of coronary atherosclerosis in young men
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DOI：
10.1161/01.cir.0000018121.67607.ce
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发表时间：
2002-06-11
期刊：
影响因子：
37.8
通讯作者：
Strong, JP
中科院分区：
文献类型：
--
作者：
McGill, HC;McMahan, CA;Strong, JP
背景-肥胖是成人冠心病的危险因素，在青年和成人中的患病率都在增加。肥胖与动脉粥样硬化的关系的结果是相互矛盾的，特别是当分析考虑到其他危险因素时，方法和结果--青年动脉粥样硬化的病理生物学决定因素（PDAY）研究收集了大约3000名年龄在15至34岁之间死于外部原因的人的动脉、血液和其他组织，并在法医实验室进行了尸检。我们测量了右冠状动脉（RCA）的总动脉粥样硬化病变，美国心脏协会（AHA）左前降支冠状动脉（LAD）病变分级，血脂浓度，血清硫氰酸盐（吸烟），肾动脉内膜厚度（高血压），糖化血红蛋白（高血糖），肥胖的体重指数（BMI）和脂膜厚度。年轻男性的BMI与RCA中的脂肪条纹和隆起病变以及LAD中的AHA分级和类固醇相关。肥胖（BMI>30 kg/m2）对RCA隆起病变的影响在脂膜厚的年轻男性中更大。肥胖与非高密度脂蛋白和高密度脂蛋白胆固醇浓度、吸烟、高血压和糖化血红蛋白浓度呈负相关，这些变量约占肥胖对年轻男性冠状动脉粥样硬化影响的15%。BMI与年轻女性的冠状动脉粥样硬化不相关，尽管在那些具有厚脂膜的人中存在趋势。结论肥胖与青少年和年轻成年男性的冠状动脉粥样硬化加速相关。这些观察结果支持了目前对控制肥胖以预防成人冠心病的重视。
Background-Obesity is a risk factor for adult coronary heart disease and is increasing in prevalence among youths as well as adults. Results regarding the association of obesity with atherosclerosis are conflicting, particularly when analyses account for other risk factors.Methods and Results-The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study collected arteries, blood, and other tissue from approximate to3000 persons aged 15 to 34 years dying of external causes and autopsied in forensic laboratories. We measured gross atherosclerotic lesions in the right coronary artery (RCA), American Heart Association (AHA) lesion grade in the left anterior descending coronary artery (LAD), serum lipid concentrations, serum thiocyanate (for smoking), intimal thickness of renal arteries (for hypertension), glycohemoglobin (for hyperalycemia), and adiposity by body mass index (BMI) and thickness of the panniculus adiposus. BMI in young men was associated with both fatty streaks and raised lesions in the RCA and with AHA grade and sterrosis in the LAD. The effect of obesity (BMI>30 kg/m(2)) on RCA raised lesions was greater in young men with a thick panniculus adiposus. Obesity was associated with non-HDL and HDL (inversely) cholesterol concentrations, smoking (inversely), hypertension, and glycohemoglobin concentration, and these variables accounted for approximate to15% of the effect of obesity on coronary atherosclerosis in young men. BMI was not associated with coronary atherosclerosis in young women although there was trend among those with a thick panniculus adiposus.Conclusions-Obesity is associated with accelerated coronary atherosclerosis in adolescent and young adult men. These observations support the current emphasis on controlling obesity to prevent adult coronary heart disease.