Visseral adipozite indeksi ile koroner arter hastalığı arasındaki ilişki
Öz
Amaç: Koroner
arter hastalığı (KAH) tüm dünyada morbidite ve mortalitenin önemli bir
nedenidir. KAH riski açısından visseral adipozite, tek başına kilo
fazlalığından daha değerli bir göstergedir. Biz bu çalışmada, tanı amaçlı
elektif koroner anjiyografi yapılan hastalarda visseral adipozite indeksi (VAİ)
ile KAH varlığı ve ciddiyeti arasındaki ilişkiyi değerlendirmeyi amaçladık.
Yöntem: Bu
retrospektif çalışmada, kliniğimizde Ocak 2018 – Aralık 2018 tarihleri arasında
tanısal koroner anjiyografi uygulanan 120 hastanın verileri kullanıldı. Koroner
anjiyografiler geriye dönük olarak incelendi. En az bir koroner arterinde %50
ve üzerinde darlığı olan hastalar KAH grubuna (n=75), belirgin koroner darlığı
olmayan hastalar (n=45) kontrol grubuna alındı. Hastaların demografik
özellikleri, boy, kilo, bel çevreleri ve tetkik sonuçları kaydedildi. VAİ
skorları kadın ve erkek hastalar için ayrı ayrı hesaplandı.
Bulgular: Kontrol
grubu ile karşılaştırıldığında, açlık serum glukoz (p=0.025) ve VAİ (p = 0.014)
KAH grubunda anlamlı olarak yüksek bulundu. KAH grubunda SYNTAX skoru, açlık
glukoz (p = 0.011), trigliserid (p = 0.048) ve VAİ (p=0.003) ile pozitif olarak
korele idi. Çok değişkenli doğrusal regresyon analizinde, açlık serum glukozu (p=0.012) ve VAİ (p =0.008)
SYNTAX
skorunun bağımsız prediktörü olarak tespit edildi.
Sonuç: Koroner
arter hastalığının takibinde değiştirilebilir risk faktörlerinin belirlenmesi
ve yönetimi çok önemlidir. Basit bir skorlama olan VAİ, KAH riskini belirlemek için kullanışlı bir
yöntem olabilir.
Anahtar Sözcükler: Koroner
arter hastalığı; Obezite; Visseral adipozite
Anahtar Kelimeler
Destekleyen Kurum
Yok
Teşekkür
Çıkar çatışması yoktur.
Kaynakça
- KAYNAKLAR1.Hennekens CH. Increasing burden of cardiovascular disease: current knowledge and future directions for research on risk factors. Circulation. 1998;97(11):1095-102.
- 2.Lennon RP, Claussen KA, Kuersteiner KA. State of the Heart: An Overview of the Disease Burden of Cardiovascular Disease from an Epidemiologic Perspective. Primary care. 2018;45(1):1-15.
- 3.Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arteriosclerosis, thrombosis, and vascular biology. 2006;26(5):968-76.
- 4.Roberson LL, Aneni EC, Maziak W, Agatston A, Feldman T, Rouseff M, et al. Beyond BMI: The "Metabolically healthy obese" phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality -- a systematic review. BMC public health. 2014;14:14.
- 5.Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes care. 2010;33(4):920-2.
- 6.Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2005;1(2):219-27.
- 7.Davidson MH. Cardiovascular risk factors in a patient with diabetes mellitus and coronary artery disease: therapeutic approaches to improve outcomes: perspectives of a preventive cardiologist. The American journal of cardiology. 2012;110(9 Suppl):43b-9b.
- 8.Hanna-Moussa A, Gardner MJ, Kurukulasuriya LR, Sowers JR. Dysglycemia/prediabetes and cardiovascular risk factors. Reviews in cardiovascular medicine. 2009;10(4):202-8.
- 9.Schinner S, Futh R, Kempf K, Martin S, Willenberg HS, Schott M, et al. A progressive increase in cardiovascular risk assessed by coronary angiography in non-diabetic patients at sub-diabetic glucose levels. Cardiovascular diabetology. 2011;10:56.
- 10.Shimabukuro M, Kozuka C, Taira S, Yabiku K, Dagvasumberel M, Ishida M, et al. Ectopic fat deposition and global cardiometabolic risk: new paradigm in cardiovascular medicine. The journal of medical investigation : JMI. 2013;60(1-2):1-14.
- 11.Han L, Fu KL, Zhao J, Wang ZH, Tang MX, Wang J, et al. Visceral adiposity index score indicated the severity of coronary heart disease in Chinese adults. Diabetology & metabolic syndrome. 2014;6(1):143.
The relationship between visceral adiposity index and coronary artery disease
Öz
Aim: Coronary
artery disease (CAD) is an important cause of morbidity and mortality
worldwide. In terms of CAD risk, visceral adiposity is a more valuable
indicator than weight alone. In this study, we aimed to evaluate the relation
of visceral adiposity index (VAI) with the presence and severity of CAD in
patients undergoing diagnostic coronary angiography.
Methods: In
this retrospective study, data of 120 patients who underwent diagnostic
coronary angiography between January 2018 and December 2018 were used. Coronary
angiograms of the patients were evaluated retrospectively. Patients with at
least 50% stenosis in one or more coronary artery were included in the CAD group
(n = 75) and patients without significant coronary stenosis (n = 45) were
included in the control group. Demographic characteristics, height, weight,
waist circumference and laboratory results were recorded. VAI scores were
calculated separately for male and female patients.
Results: Fasting
serum glucose (p = 0.025) and VAI (p = 0.014) were significantly higher in CAD
group when compared with control group. SYNTAX score was positively correlated
with fasting glucose (p = 0.011), triglyceride (p = 0.048) and VAI (p = 0.003)
in the CAD group. In multivariate linear regression analysis, fasting serum
glucose (p = 0.012) and VAI (p = 0.008) were determined as independent
predictors of SYNTAX score.
Conclusion: The
determination and management of modifiable risk factors is very important in
the follow-up of patients with CAD. As a simple scoring method, VAI may be
useful for determining the risk of CAD.
Keywords: Coronary
artery disease; Obesity; Visceral adiposity
Anahtar Kelimeler
Kaynakça
- KAYNAKLAR1.Hennekens CH. Increasing burden of cardiovascular disease: current knowledge and future directions for research on risk factors. Circulation. 1998;97(11):1095-102.
- 2.Lennon RP, Claussen KA, Kuersteiner KA. State of the Heart: An Overview of the Disease Burden of Cardiovascular Disease from an Epidemiologic Perspective. Primary care. 2018;45(1):1-15.
- 3.Poirier P, Giles TD, Bray GA, Hong Y, Stern JS, Pi-Sunyer FX, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arteriosclerosis, thrombosis, and vascular biology. 2006;26(5):968-76.
- 4.Roberson LL, Aneni EC, Maziak W, Agatston A, Feldman T, Rouseff M, et al. Beyond BMI: The "Metabolically healthy obese" phenotype & its association with clinical/subclinical cardiovascular disease and all-cause mortality -- a systematic review. BMC public health. 2014;14:14.
- 5.Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes care. 2010;33(4):920-2.
- 6.Sianos G, Morel MA, Kappetein AP, Morice MC, Colombo A, Dawkins K, et al. The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2005;1(2):219-27.
- 7.Davidson MH. Cardiovascular risk factors in a patient with diabetes mellitus and coronary artery disease: therapeutic approaches to improve outcomes: perspectives of a preventive cardiologist. The American journal of cardiology. 2012;110(9 Suppl):43b-9b.
- 8.Hanna-Moussa A, Gardner MJ, Kurukulasuriya LR, Sowers JR. Dysglycemia/prediabetes and cardiovascular risk factors. Reviews in cardiovascular medicine. 2009;10(4):202-8.
- 9.Schinner S, Futh R, Kempf K, Martin S, Willenberg HS, Schott M, et al. A progressive increase in cardiovascular risk assessed by coronary angiography in non-diabetic patients at sub-diabetic glucose levels. Cardiovascular diabetology. 2011;10:56.
- 10.Shimabukuro M, Kozuka C, Taira S, Yabiku K, Dagvasumberel M, Ishida M, et al. Ectopic fat deposition and global cardiometabolic risk: new paradigm in cardiovascular medicine. The journal of medical investigation : JMI. 2013;60(1-2):1-14.
- 11.Han L, Fu KL, Zhao J, Wang ZH, Tang MX, Wang J, et al. Visceral adiposity index score indicated the severity of coronary heart disease in Chinese adults. Diabetology & metabolic syndrome. 2014;6(1):143.