Visceral Fat Accumulation Contributes to Insulin Resistance, Small-Sized Low-Density Lipoprotein, and Progression of Coronary Artery Disease in Middle-Aged Non-Obese Japanese Men

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概要

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• Visceral fat accumulation plays an important role in the occurrence of coronary artery disease (CAD) associated with a cluster of multiple risk factors, such as glucose intolerance, insulin resistance and hyperlipoproteinemia. To clarify the detailed features of these factors, based on visceral fat accumulation, the present study examined the relationship between fat distribution and the characteristics of glucose metabolism and serum lipoproteins in middle-aged non-obese Japanese men. First, the influence of visceral fat accumulation on glucose metabolism, insulin sensitivity, and the extent and severity of coronary artery lesions was investigated in 50 subjects with CAD and compared with 15 control subjects without CAD (Study 1) and with the lipoprotein characteristics in 44 subjects without CAD who were not treated with lipid-lowering drugs (Study 2). Body fat distribution was determined by abdominal computed tomography. In Study 1, the visceral fat area (VFA), blood pressure, fasting immunoreactive insulin (FIRI), and the plasma insulin area (PIA) obtained by oral glucose tolerance test in the subjects with CAD were all significantly higher than in the control subjects. The VFA was significantly correlated with FIRI, the homeostasis model of insulin resistance, PIA and steady state plasma glucose (SSPG) concentration as an index for insulin resistance (r=0.57, p<0.001, r=0.49, p<0.01, r=0.36, p<0.01, and r=0.50, p<0.05, respectively). Although the SSPG concentration did not correlate with the coronary atherosclerosis index as a score of the extent and severity of coronary lesions, the VFA was significantly correlated with this index (r=0.43, p<0.01). In Study 2, the VFA had significant positive correlations with serum total cholesterol, triglyceride, and apolipoprotein B and E levels and the cholesterol and triglyceride concentrations of very-low-density lipoprotein, intermediate-density lipoprotein, and low-density lipoprotein (LDL) fractions. There was a negative correlation between the VFA and LDL particle size (r=-0.34, p<0.05). In conclusion, visceral fat accumulation may contribute to the development of CAD through the progression of insulin resistance and the increase of apo Bcontaining lipoproteins and small-sized LDLs in middle-aged non-obese Japanese men.

• 社団法人日本循環器学会の論文
• 2001-02-20

著者

• Yamashita Shizuya

  Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine

• Matsuzawa Yuji

  Department of Internal Medicine, Sumitomo Hospital

• Saito Y

  Chiba University

• Nishida Makoto

  Health Care Center, Osaka University

• NAKAMURA Tadashi

  Department of Metabolic Medicine, Osaka University Graduate School of Medicine

• Funahashi Tohru

  Division Of Cardiovascular Surgery Department Of Surgery Osaka University Graduate School Of Medicin

• Funahashi Tohru

  Department of Metabolic Medicine, Graduate School of Medicine

• Nishida Makoto

  Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University

• Hirobe K.azuhiko

  Department Of Cardiovascular Med. Kumamoto Univ.

• Saito Y

  Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine

• Yamashita Shizuya

  Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine

• Nishida Makoto

  Health Care Center Osaka University

• Nakajima Tadahisa

  Department Of Metabolic Medicine Osaka University Graduate School Of Medicine

• Matsuzawa Yuji

  熊本大学 医学薬学研究部循環器病態学

• Nagano M

  Health Care Center Osaka University

• Matsuzawa Y

  Department Of Metabolic Medicine Graduate School Of Medicine Osaka University

• Noritake Masayuki

  防衛医科大学校 第2内科

• Kuriyama Hiroshi

  Department Of Cardiovascular Medicine Graduate School Of Medical Sciences Kumamoto University

• Nagano Makoto

  Health Care Center Osaka University

• Nakajima Tohru

  Division Of Pediatric Cardiology Osaka Medical Center And Research Institute For Maternal And Child

• KOBAYASHI Hitoshi

  Department of Dermatology, Hokkaido University School of Medicine

• Hirobe Kazuhiko

  Center for Adult Diseases

• Miyaoka Koji

  Department of Internal Medicine and Molecular Science, Graduate School of Medicine, Osaka University

• Matsuzawa Yuji

  Department Of 2nd Internal Medicine Faculty Of Medicine Oaka University

• Kobayashi Hitoshi

  Department Of Cardiology Fukuoka Tokushukai Medical Center

• Nakamura Tadashi

  Department Of Metabolic Medicine Osaka University Graduate School Of Medicine

• Funahashi Tohru

  Department Of Cardiovascular Surgery National Cerebral And Cardiovascular Center

• Nishida Makoto

  Department Of Electrical Engineering Faculty Of Mining Akita University

• Nakamura Tadashi

  Department Of Anesthesia Junwakai Memorial Hospital

• Miyaoka Koji

  Department Of Internal Medicine And Molecular Science Graduate School Of Medicine Osaka University

• Yamashita Shizuya

  Department Of Cardiovascular Medicine Juntendo University School Of Medicine

• Kobayashi Hitoshi

  Department Of Biology Faculty Of Science Osaka University

• Tominaga Norio

  Division Of Pediatric Cardiology Osaka Medical Center And Research Institute For Maternal And Child Health

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