VİSSERAL ADİPOZİTE İNDEKSİ İLE KORONER ARTER HASTALIĞI ARASINDAKİ İLİŞKİ The Relationship Between Visceral Adiposity Index And Coronary Artery Disease

Yıl 2019, Cilt: 9 Sayı: 3, 129 - 133, 16.09.2019

Yaşar Turan Vahit Demir

Öz

ÖZET

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

ABSTRACT

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 followup

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

VİSSERAL ADİPOZİTE İNDEKSİ İLE KORONER ARTER HASTALIĞI ARASINDAKİ İLİŞKİ The Relationship Between Visceral Adiposity Index And Coronary Artery Disease

Kaynakça

• 1. 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.