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Жесткость сосудистой стенки у лиц молодого возраста с абдоминальным ожирением и ее связь с разными жировыми депо
Жесткость сосудистой стенки у лиц молодого возраста с абдоминальным ожирением и ее связь с разными жировыми депо
Железнова Е.А., Жернакова Ю.В., Чазова И.Е. и др. Жесткость сосудистой стенки у лиц молодого возраста с абдоминальным ожирением и ее связь с разными жировыми депо. Системные гипертензии. 2018; 15 (4): 76–82. DOI: 10.26442/2075082X.2018.4.180131
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Аннотация
Ожирение играет ключевую роль в эпидемии сахарного диабета (СД) 2-го типа и ассоциированных с ним сердечно-сосудистых и цереброваскулярных заболеваний. Большинство исследований подтверждает связь повышенной жесткости артерий с ожирением. Однако взаимосвязь разных жировых депо с одним из основных показателей жесткости сосудистой стенки – сердечно-лодыжечным сосудистым индексом (CAVI) в настоящее время изучена недостаточно.
Цель исследования – оценка жесткости сосудистой стенки у лиц молодого возраста с абдоминальным ожирением (АО) без метаболического синдрома (МС) и с МС, связи жировых депо (висцерального, подкожного, периваскулярного, эпикардиального жира) с параметром жесткости CAVI.
Материалы и методы. 68 человек с АО в возрасте 18–45 лет. Включенным в исследование были измерены рост, масса тела, индекс массы тела (ИМТ), окружность талии, определены биохимический анализ крови (глюкоза тощаковая и в ходе теста толерантности к глюкозе, мочевая кислота, креатинин, скорость клубочковой фильтрации), липидный профиль, инсулин, индекс инсулинорезистентности – HOMA-IR. Были выполнены: суточное мониторирование артериального давления (АД), компьютерная томография (Aquilion One Vision Edition, Toshiba, Япония) с определением подкожного, висцерального, периваскулярного, эпикардиального жира, а также рассчитывалось отношение подкожного к висцеральному жиру. Для оценки жесткости сосудистой стенки определялся CAVI на аппарате VaSera 1000 (Fukuda Denshi, Япония). Для анализа были сформированы 2 группы: лица с АО и наличием не более чем одного дополнительного фактора риска (метаболически здоровые) – 1-я группа, лица с МС (АО в сочетании с 2 и более дополнительными факторами риска) – 2-я группа, контрольную группу составили здоровые лица (n=15) без ожирения – 0-я группа.
Результаты. Статистически значимого различия по CAVI между группами получено не было. Выявлены корреляционные связи CAVI с возрастом: r=0,340 (p=0,005), дневным средним систолическим АД – САДср (r=0,280, p=0,021) и средним диастолическим АД – ДАДср (r= 0,329, p=0,006), ночным САДср (r=0,233, p=0,014) и ДАДср (r=0,297, p=0,014), объемом периаортального жира (r=0,218, p=0,074). Выявлена обратная корреляционная связь CAVI с ИМТ (r=-0,279, p=0,021), подкожным жировым депо (r=-0,285, p=0,019) и отношением подкожного жира к висцеральному (r=-0,303, p=0,012). По данным многофакторного регрессионного анализа наиболее значимое влияние на CAVI оказывают возраст, САДср, ИМТ и объем периаортального жира.
Ключевые слова: метаболический синдром, жировые депо, жесткость сосудов, артериальная гипертония, ожирение, избыточная масса тела.
The purpose of this study is to assess arterial stiffness in people with abdominal obesity without metabolic syndrome (MS) and with MS, the connection of fat depots (visceral, subcutaneous, perivascular, epicardial fat) with the stiffness parameter CAVI.
Materials and methods. 68 people with abdominal obesity (AO) at the age of 18–45 years. The study included height, weight, BMI, waist circumference, and biochemical blood tests (fast glucose and glucose tolerance, uric acid, creatinine, GFR – MDRD, lipid profile, insulin, HOMA-IR). 24-hour blood pressure monitoring, computed tomography (Aquilion One Vision Edition, Toshiba, Japan) with the definition of subcutaneous, visceral, perivascular, epicardial fat, and also calculated the ratio subcutaneous to visceral fat. It was determined CAVI on the VaSera 1000 unit (Fukuda Denshi, Japan) to assess arterial stiffness. Abdominal obesity was derteming by cut off waist circumference >80 cm for women and >94 cm for men. As a result, we were formed 2 groups: persons with abdominal obesity and the presence of no more than one additional risk factor (metabolically healthy) – group 1, persons with MS (abdominal obesity in combination with 2 and more extra risk factors) – group 2, the control group consisted of healthy individuals (n=15) without obesity – group 0.
Results. There was no statistically significant difference between CAVI groups. Correlations of CAVI with age r=0.340 (p=0.005), with daytime mean systolic blood pressure – SBPm average (r=0.280, p=0.021) and with mean diastolic blood pressure – DBPm average (r=0.329, p=0.006), with night SBPm average (r=0.233, p=0.014) and with DBPm average (r=0.297, p=0.014), with the volume of periaortic fat (r=0.218, p=0.074) were found. An inverse correlation was found between CAVI and BMI (r=-0.279, p=0.021), with subcutaneous fat depot (r=-0.285, p=0.019) and with the ratio of subcutaneous to visceral fat (r=-0.303, p=0.012). According to the multivariate regression analysis, the most significant impact on CAVI is exerted by age, daytime SBPm, BMI, and the volume of periaortic fat.
Key words: metabolic syndrome, fat depots, vascular stiffness, arterial hypertension, obesity, overweight.
Цель исследования – оценка жесткости сосудистой стенки у лиц молодого возраста с абдоминальным ожирением (АО) без метаболического синдрома (МС) и с МС, связи жировых депо (висцерального, подкожного, периваскулярного, эпикардиального жира) с параметром жесткости CAVI.
Материалы и методы. 68 человек с АО в возрасте 18–45 лет. Включенным в исследование были измерены рост, масса тела, индекс массы тела (ИМТ), окружность талии, определены биохимический анализ крови (глюкоза тощаковая и в ходе теста толерантности к глюкозе, мочевая кислота, креатинин, скорость клубочковой фильтрации), липидный профиль, инсулин, индекс инсулинорезистентности – HOMA-IR. Были выполнены: суточное мониторирование артериального давления (АД), компьютерная томография (Aquilion One Vision Edition, Toshiba, Япония) с определением подкожного, висцерального, периваскулярного, эпикардиального жира, а также рассчитывалось отношение подкожного к висцеральному жиру. Для оценки жесткости сосудистой стенки определялся CAVI на аппарате VaSera 1000 (Fukuda Denshi, Япония). Для анализа были сформированы 2 группы: лица с АО и наличием не более чем одного дополнительного фактора риска (метаболически здоровые) – 1-я группа, лица с МС (АО в сочетании с 2 и более дополнительными факторами риска) – 2-я группа, контрольную группу составили здоровые лица (n=15) без ожирения – 0-я группа.
Результаты. Статистически значимого различия по CAVI между группами получено не было. Выявлены корреляционные связи CAVI с возрастом: r=0,340 (p=0,005), дневным средним систолическим АД – САДср (r=0,280, p=0,021) и средним диастолическим АД – ДАДср (r= 0,329, p=0,006), ночным САДср (r=0,233, p=0,014) и ДАДср (r=0,297, p=0,014), объемом периаортального жира (r=0,218, p=0,074). Выявлена обратная корреляционная связь CAVI с ИМТ (r=-0,279, p=0,021), подкожным жировым депо (r=-0,285, p=0,019) и отношением подкожного жира к висцеральному (r=-0,303, p=0,012). По данным многофакторного регрессионного анализа наиболее значимое влияние на CAVI оказывают возраст, САДср, ИМТ и объем периаортального жира.
Ключевые слова: метаболический синдром, жировые депо, жесткость сосудов, артериальная гипертония, ожирение, избыточная масса тела.
________________________________________________
The purpose of this study is to assess arterial stiffness in people with abdominal obesity without metabolic syndrome (MS) and with MS, the connection of fat depots (visceral, subcutaneous, perivascular, epicardial fat) with the stiffness parameter CAVI.
Materials and methods. 68 people with abdominal obesity (AO) at the age of 18–45 years. The study included height, weight, BMI, waist circumference, and biochemical blood tests (fast glucose and glucose tolerance, uric acid, creatinine, GFR – MDRD, lipid profile, insulin, HOMA-IR). 24-hour blood pressure monitoring, computed tomography (Aquilion One Vision Edition, Toshiba, Japan) with the definition of subcutaneous, visceral, perivascular, epicardial fat, and also calculated the ratio subcutaneous to visceral fat. It was determined CAVI on the VaSera 1000 unit (Fukuda Denshi, Japan) to assess arterial stiffness. Abdominal obesity was derteming by cut off waist circumference >80 cm for women and >94 cm for men. As a result, we were formed 2 groups: persons with abdominal obesity and the presence of no more than one additional risk factor (metabolically healthy) – group 1, persons with MS (abdominal obesity in combination with 2 and more extra risk factors) – group 2, the control group consisted of healthy individuals (n=15) without obesity – group 0.
Results. There was no statistically significant difference between CAVI groups. Correlations of CAVI with age r=0.340 (p=0.005), with daytime mean systolic blood pressure – SBPm average (r=0.280, p=0.021) and with mean diastolic blood pressure – DBPm average (r=0.329, p=0.006), with night SBPm average (r=0.233, p=0.014) and with DBPm average (r=0.297, p=0.014), with the volume of periaortic fat (r=0.218, p=0.074) were found. An inverse correlation was found between CAVI and BMI (r=-0.279, p=0.021), with subcutaneous fat depot (r=-0.285, p=0.019) and with the ratio of subcutaneous to visceral fat (r=-0.303, p=0.012). According to the multivariate regression analysis, the most significant impact on CAVI is exerted by age, daytime SBPm, BMI, and the volume of periaortic fat.
Key words: metabolic syndrome, fat depots, vascular stiffness, arterial hypertension, obesity, overweight.
Полный текст
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2. Hajian-Tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults? Int J Prev Med 2015; 6: 5.
3. Smith SC. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med 2007; 120 (3, Suppl. 1): S3–S11.
4. Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998; 97 (21): 2099–100.
5. National Center for Health Statistics (US), Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. Hyattsville (MD): National Center for Health Statistics (US), 2016.
6. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res 1998; 6 (2): 97–106.
7. Prevalence of obesity, central obesity and the associated factors in urban population aged 20–70 years, in the north of Iran: a population-based study and regression approach. https://www.wizdom.ai/publication/10.1111/J.1467-789X.2006.00235.X/title/prevalence_of_obesity_centr... north_of_iran_a_population_based_study_and_regression_approach.
8. GBD 2015 Obesity Collaborators et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017; 377 (1): 13–27.
9. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Institute for Health Metrics and Evaluation. http://www.healthdata.org/research-article/global-regional-and-national-prevalence-overweight-and-ob...
10. Hales CM, Fryar CD, Carroll MD et al. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007–2008 to 2015–2016. JAMA 2018; 319 (16): 1723–5.
11. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. PubMed – NCBI. https://www.ncbi.nlm.nih.gov/pubmed/?term=Association+of+all-cause+mortality+with+overweight+and+obe...
12. Balanova Iu.A., Shal'nova S.A., Deev A.D. i dr. Ozhirenie v rossiiskoi populiatsii – rasprostranennost' i assotsiatsii s faktorami riska khronicheskikh neinfektsionnykh zabolevanii. https://cyberleninka.ru/article/n/ozhirenie-v-rossiyskoy-populyatsii-rasprostranennost-i-assotsiatsi... [in Russian]
13. Body composition of Canadian adults, 2009 to 2011. https://www150.statcan.gc.ca/n1/pub/82-625-x/2012001/article/11708-eng.htm
14. Poirier P et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113 (6): 898–918.
15. Emerging Risk Factors Collaboration et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet Lond Engl 2011; 377 (9771): 1085–95.
16. Piché M-E, Poirier P, Lemieux I, Després J-P. Overview of Epidemiology and Contribution of Obesity and Body Fat Distribution to Cardiovascular Disease: An Update. Prog Cardiovasc Dis 2018; 61 (2): 103–13.
17. Tate RB, St John PD. Sudden Unexpected Cardiac Death on Monday in Younger and Older Men: The Manitoba Follow-up Study. Am J Epidemiol 2018; 187 (3): 633–5.
18. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67 (5): 968–77.
19. Plourde B, Sarrazin J-F, Nault I, Poirier P. Sudden cardiac death and obesity. Exp Rev Cardiovasc Ther 2014; 12 (9): 1099–10.
20. Poirier P et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation 2011; 123 (15): 1683–701.
21. Goossens GH. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obes Facts 2017; 10 (3): 207–15.
22. Wajchenberg BL. Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome. Endocr Rev 2000; 21 (6): 697–738.
23. Alexopoulos N, Katritsis D, Raggi P. Visceral adipose tissue as a source of inflammation and promoter of atherosclerosis. Atherosclerosis 2014; 233 (1): 104–12.
24. Britton KA, Massaro JM, Murabito JM et al. Body Fat Distribution, Incident Cardiovascular Disease, Cancer, and All-Cause Mortality. J Am Coll Cardiol 2013; 62 (10): 921–5.
25. General and abdominal obesity and abdominal visceral fat accumulation associated with coronary artery calcification in Korean men – ScienceDirect. https://www.sciencedirect.com/ science/article/pii/S0021915010005976
26. Ohashi N et al. Visceral fat accumulation as a predictor of coronary artery calcium as assessed by multislice computed tomography in Japanese patients. Atherosclerosis 2009; 202 (1): 192–9.
27. Imai A et al. Visceral abdominal fat accumulation predicts the progression of noncalcified coronary plaque. Atherosclerosis 2012; 222 (2): 524–9.
28. Lehman SJ, Massaro JM, Schlett CL et al. Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: the Framingham Heart Study. Atherosclerosis 2010; 210 (2): 656–61.
29. Britton KA et al. Prevalence, Distribution, and Risk Factor Correlates of High Thoracic Periaortic Fat in the Framingham Heart Study. J Am Heart Assoc 2012; 1 (6): e004200.
30. Fox CS et al. Periaortic fat deposition is associated with peripheral arterial disease: the Framingham heart study. Circ Cardiovasc Imaging 2010; 3 (5): 515–9.
31. Öhman MK et al. Perivascular Visceral Adipose Tissue Induces Atherosclerosis in Apolipoprotein E Deficient. Atherosclerosis 2011; 219 (1): 33–9.
32. Epicardial Adipose Tissue as a Predictor of Coronary Artery Disease in Asymptomatic Subjects – Science Direct. https://www.sciencedirect.com/science/article/pii/S0002914912011848
33. Alexopoulos N, McLean DS, Janik M et al. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis 2010; 210 (1): 150–4.
34. Yun C-H et al. Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks. Eur J Radiol 2012; 81 (4): 749–56.
35. Yun C-H et al. The Normal Limits, Subclinical Significance, Related Metabolic Derangements and Distinct Biological Effects of Body Site-Specific Adiposity in Relatively Healthy Population. PLOS ONE 2013; 8 (4): e61997.
36. Nakanishi R et al. Increase in epicardial fat volume is associated with greater coronary artery calcification progression in subjects at intermediate risk by coronary calcium score: A serial study using non-contrast cardiac CT. Atherosclerosis 2011; 218 (2): 363–8.
37. Zairova AR et al. Arterial stiffness and vascular aging in relation to coalugogical CVD risk factors, parameters of lipid and carbohydrate metabolism in adult population of Tomsk in the framework of the project ESSE-RF. Kardiologicheskii Vestn. 2018; 13 (1): 5.
38. Liu H, Zhang X, Feng X et al. Effects of metabolic syndrome on cardio-ankle vascular index in middle-aged and elderly Chinese. Metab Syndr Relat Disord 2011; 9 (2): 105–10.
39. Satoh N et al. Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertens Res Off J Jpn Soc Hypertens 2008; 31 (10): 1921–30.
40. Gomez-Sanchez L et al. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol 2016; 15 (1): 148.
41. Homsi R et al. Epicardial Fat Volume and Aortic Stiffness in Healthy Individuals: A Quantitative Cardiac Magnetic Resonance Study. ROFO. Fortschr Geb Rontgenstr Nuklearmed 2016; 188 (9): 853–8.
42. Altun I et al. Increased Epicardial Fat Thickness Correlates with Aortic Stiffness and N-Terminal Pro-Brain Natriuretic Peptide Levels in Acute Ischemic Stroke Patients. Tex Heart Inst J 2016; 43 (3): 220–6.
43. Ohashi N, Ito C, Fujikawa R et al. The impact of visceral adipose tissue and high-molecular weight adiponectin on cardio-ankle vascular index in asymptomatic Japanese subjects. Metabolism 2009; 58 (7): 1023–9.
44. Park HE, Choi S-Y, Kim HS et al. Epicardial fat reflects arterial stiffness: assessment using 256-slice multidetector coronary computed tomography and cardio-ankle vascular index. J Atheroscler Thromb 2012; 19 (6): 570–6.
45. Strasser B, Arvandi M, Pasha EP et al. Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 2015; 25 (5): 495–502.
46. Matthews DR, Hosker JP, Rudenski AS et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28 (7); 412–9.
47. Thanassoulis G et al. Prevalence, distribution, and risk factor correlates of high pericardial and intrathoracic fat depots in the Framingham heart study. Circ Cardiovasc Imaging 2010; 3 (5); 559–66.
48. Sarin S et al. Clinical significance of epicardial fat measured using cardiac multislice computed tomography. Am J Cardiol 2008; 102 (6): 767–71.
49. Takaki A et al. Cardio-ankle vascular index is superior to brachial-ankle pulse wave velocity as an index of arterial stiffness. Hypertens Res Off J Jpn Soc Hypertens 2008; 31 (7): 1347–55.
50. Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013; 93 (1): 359–404.
51. Bucci Marco et al. Intrapericardial, But Not Extrapericardial, Fat Is an Independent Predictor of Impaired Hyperemic Coronary Perfusion in Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2011; 31 (1): 211–8.
52. Otaki Y et al. The relationship between epicardial fat volume and incident coronary artery calcium. J Cardiovasc Comput Tomogr 2011; 5 (5): 310–6.
53. Yerramasu A et al. Increased volume of epicardial fat is an independent risk factor for accelerated progression of sub-clinical coronary atherosclerosis. Atherosclerosis 2012; 220 (1): 223–30.
54. Xia N, Li H. The role of perivascular adipose tissue in obesity-induced vascular dysfunction. Br J Pharmacol 2017; 174 (20): 3425–42.
55. Fernández-Alfonso MS, Gil-Ortega M, García-Prieto CF et al. Mechanisms of perivascular adipose tissue dysfunction in obesity. Int J Endocrinol 2013; 2013: 402053.
2. Hajian-Tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults? Int J Prev Med 2015; 6: 5.
3. Smith SC. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med 2007; 120 (3, Suppl. 1): S3–S11.
4. Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998; 97 (21): 2099–100.
5. National Center for Health Statistics (US), Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. Hyattsville (MD): National Center for Health Statistics (US), 2016.
6. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res 1998; 6 (2): 97–106.
7. Prevalence of obesity, central obesity and the associated factors in urban population aged 20–70 years, in the north of Iran: a population-based study and regression approach. https://www.wizdom.ai/publication/10.1111/J.1467-789X.2006.00235.X/title/prevalence_of_obesity_centr... north_of_iran_a_population_based_study_and_regression_approach.
8. GBD 2015 Obesity Collaborators et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017; 377 (1): 13–27.
9. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Institute for Health Metrics and Evaluation. http://www.healthdata.org/research-article/global-regional-and-national-prevalence-overweight-and-ob...
10. Hales CM, Fryar CD, Carroll MD et al. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007–2008 to 2015–2016. JAMA 2018; 319 (16): 1723–5.
11. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. PubMed – NCBI. https://www.ncbi.nlm.nih.gov/pubmed/?term=Association+of+all-cause+mortality+with+overweight+and+obe...
12. Баланова Ю.А., Шальнова С.А., Деев А.Д. и др. Ожирение в российской популяции – распространенность и ассоциации с факторами риска хронических неинфекционных заболеваний. https://cyberleninka.ru/article/n/ozhirenie-v-rossiyskoy-populyatsii-rasprostranennost-i-assotsiatsi... / Balanova Iu.A., Shal'nova S.A., Deev A.D. i dr. Ozhirenie v rossiiskoi populiatsii – rasprostranennost' i assotsiatsii s faktorami riska khronicheskikh neinfektsionnykh zabolevanii. https://cyberleninka.ru/article/n/ozhirenie-v-rossiyskoy-populyatsii-rasprostranennost-i-assotsiatsi... [in Russian]
13. Body composition of Canadian adults, 2009 to 2011. https://www150.statcan.gc.ca/n1/pub/82-625-x/2012001/article/11708-eng.htm
14. Poirier P et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113 (6): 898–918.
15. Emerging Risk Factors Collaboration et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet Lond Engl 2011; 377 (9771): 1085–95.
16. Piché M-E, Poirier P, Lemieux I, Després J-P. Overview of Epidemiology and Contribution of Obesity and Body Fat Distribution to Cardiovascular Disease: An Update. Prog Cardiovasc Dis 2018; 61 (2): 103–13.
17. Tate RB, St John PD. Sudden Unexpected Cardiac Death on Monday in Younger and Older Men: The Manitoba Follow-up Study. Am J Epidemiol 2018; 187 (3): 633–5.
18. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67 (5): 968–77.
19. Plourde B, Sarrazin J-F, Nault I, Poirier P. Sudden cardiac death and obesity. Exp Rev Cardiovasc Ther 2014; 12 (9): 1099–10.
20. Poirier P et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation 2011; 123 (15): 1683–701.
21. Goossens GH. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obes Facts 2017; 10 (3): 207–15.
22. Wajchenberg BL. Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome. Endocr Rev 2000; 21 (6): 697–738.
23. Alexopoulos N, Katritsis D, Raggi P. Visceral adipose tissue as a source of inflammation and promoter of atherosclerosis. Atherosclerosis 2014; 233 (1): 104–12.
24. Britton KA, Massaro JM, Murabito JM et al. Body Fat Distribution, Incident Cardiovascular Disease, Cancer, and All-Cause Mortality. J Am Coll Cardiol 2013; 62 (10): 921–5.
25. General and abdominal obesity and abdominal visceral fat accumulation associated with coronary artery calcification in Korean men – ScienceDirect. https://www.sciencedirect.com/ science/article/pii/S0021915010005976
26. Ohashi N et al. Visceral fat accumulation as a predictor of coronary artery calcium as assessed by multislice computed tomography in Japanese patients. Atherosclerosis 2009; 202 (1): 192–9.
27. Imai A et al. Visceral abdominal fat accumulation predicts the progression of noncalcified coronary plaque. Atherosclerosis 2012; 222 (2): 524–9.
28. Lehman SJ, Massaro JM, Schlett CL et al. Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: the Framingham Heart Study. Atherosclerosis 2010; 210 (2): 656–61.
29. Britton KA et al. Prevalence, Distribution, and Risk Factor Correlates of High Thoracic Periaortic Fat in the Framingham Heart Study. J Am Heart Assoc 2012; 1 (6): e004200.
30. Fox CS et al. Periaortic fat deposition is associated with peripheral arterial disease: the Framingham heart study. Circ Cardiovasc Imaging 2010; 3 (5): 515–9.
31. Öhman MK et al. Perivascular Visceral Adipose Tissue Induces Atherosclerosis in Apolipoprotein E Deficient. Atherosclerosis 2011; 219 (1): 33–9.
32. Epicardial Adipose Tissue as a Predictor of Coronary Artery Disease in Asymptomatic Subjects – Science Direct. https://www.sciencedirect.com/science/article/pii/S0002914912011848
33. Alexopoulos N, McLean DS, Janik M et al. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis 2010; 210 (1): 150–4.
34. Yun C-H et al. Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks. Eur J Radiol 2012; 81 (4): 749–56.
35. Yun C-H et al. The Normal Limits, Subclinical Significance, Related Metabolic Derangements and Distinct Biological Effects of Body Site-Specific Adiposity in Relatively Healthy Population. PLOS ONE 2013; 8 (4): e61997.
36. Nakanishi R et al. Increase in epicardial fat volume is associated with greater coronary artery calcification progression in subjects at intermediate risk by coronary calcium score: A serial study using non-contrast cardiac CT. Atherosclerosis 2011; 218 (2): 363–8.
37. Zairova AR et al. Arterial stiffness and vascular aging in relation to coalugogical CVD risk factors, parameters of lipid and carbohydrate metabolism in adult population of Tomsk in the framework of the project ESSE-RF. Kardiologicheskii Vestn. 2018; 13 (1): 5.
38. Liu H, Zhang X, Feng X et al. Effects of metabolic syndrome on cardio-ankle vascular index in middle-aged and elderly Chinese. Metab Syndr Relat Disord 2011; 9 (2): 105–10.
39. Satoh N et al. Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertens Res Off J Jpn Soc Hypertens 2008; 31 (10): 1921–30.
40. Gomez-Sanchez L et al. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol 2016; 15 (1): 148.
41. Homsi R et al. Epicardial Fat Volume and Aortic Stiffness in Healthy Individuals: A Quantitative Cardiac Magnetic Resonance Study. ROFO. Fortschr Geb Rontgenstr Nuklearmed 2016; 188 (9): 853–8.
42. Altun I et al. Increased Epicardial Fat Thickness Correlates with Aortic Stiffness and N-Terminal Pro-Brain Natriuretic Peptide Levels in Acute Ischemic Stroke Patients. Tex Heart Inst J 2016; 43 (3): 220–6.
43. Ohashi N, Ito C, Fujikawa R et al. The impact of visceral adipose tissue and high-molecular weight adiponectin on cardio-ankle vascular index in asymptomatic Japanese subjects. Metabolism 2009; 58 (7): 1023–9.
44. Park HE, Choi S-Y, Kim HS et al. Epicardial fat reflects arterial stiffness: assessment using 256-slice multidetector coronary computed tomography and cardio-ankle vascular index. J Atheroscler Thromb 2012; 19 (6): 570–6.
45. Strasser B, Arvandi M, Pasha EP et al. Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 2015; 25 (5): 495–502.
46. Matthews DR, Hosker JP, Rudenski AS et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28 (7); 412–9.
47. Thanassoulis G et al. Prevalence, distribution, and risk factor correlates of high pericardial and intrathoracic fat depots in the Framingham heart study. Circ Cardiovasc Imaging 2010; 3 (5); 559–66.
48. Sarin S et al. Clinical significance of epicardial fat measured using cardiac multislice computed tomography. Am J Cardiol 2008; 102 (6): 767–71.
49. Takaki A et al. Cardio-ankle vascular index is superior to brachial-ankle pulse wave velocity as an index of arterial stiffness. Hypertens Res Off J Jpn Soc Hypertens 2008; 31 (7): 1347–55.
50. Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013; 93 (1): 359–404.
51. Bucci Marco et al. Intrapericardial, But Not Extrapericardial, Fat Is an Independent Predictor of Impaired Hyperemic Coronary Perfusion in Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2011; 31 (1): 211–8.
52. Otaki Y et al. The relationship between epicardial fat volume and incident coronary artery calcium. J Cardiovasc Comput Tomogr 2011; 5 (5): 310–6.
53. Yerramasu A et al. Increased volume of epicardial fat is an independent risk factor for accelerated progression of sub-clinical coronary atherosclerosis. Atherosclerosis 2012; 220 (1): 223–30.
54. Xia N, Li H. The role of perivascular adipose tissue in obesity-induced vascular dysfunction. Br J Pharmacol 2017; 174 (20): 3425–42.
55. Fernández-Alfonso MS, Gil-Ortega M, García-Prieto CF et al. Mechanisms of perivascular adipose tissue dysfunction in obesity. Int J Endocrinol 2013; 2013: 402053.
________________________________________________
2. Hajian-Tilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waist-to-height ratio in Iranian adults? Int J Prev Med 2015; 6: 5.
3. Smith SC. Multiple risk factors for cardiovascular disease and diabetes mellitus. Am J Med 2007; 120 (3, Suppl. 1): S3–S11.
4. Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998; 97 (21): 2099–100.
5. National Center for Health Statistics (US), Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. Hyattsville (MD): National Center for Health Statistics (US), 2016.
6. Wolf AM, Colditz GA. Current estimates of the economic cost of obesity in the United States. Obes Res 1998; 6 (2): 97–106.
7. Prevalence of obesity, central obesity and the associated factors in urban population aged 20–70 years, in the north of Iran: a population-based study and regression approach. https://www.wizdom.ai/publication/10.1111/J.1467-789X.2006.00235.X/title/prevalence_of_obesity_centr... north_of_iran_a_population_based_study_and_regression_approach.
8. GBD 2015 Obesity Collaborators et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med 2017; 377 (1): 13–27.
9. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Institute for Health Metrics and Evaluation. http://www.healthdata.org/research-article/global-regional-and-national-prevalence-overweight-and-ob...
10. Hales CM, Fryar CD, Carroll MD et al. Trends in Obesity and Severe Obesity Prevalence in US Youth and Adults by Sex and Age, 2007–2008 to 2015–2016. JAMA 2018; 319 (16): 1723–5.
11. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. PubMed – NCBI. https://www.ncbi.nlm.nih.gov/pubmed/?term=Association+of+all-cause+mortality+with+overweight+and+obe...
12. Balanova Iu.A., Shal'nova S.A., Deev A.D. i dr. Ozhirenie v rossiiskoi populiatsii – rasprostranennost' i assotsiatsii s faktorami riska khronicheskikh neinfektsionnykh zabolevanii. https://cyberleninka.ru/article/n/ozhirenie-v-rossiyskoy-populyatsii-rasprostranennost-i-assotsiatsi... [in Russian]
13. Body composition of Canadian adults, 2009 to 2011. https://www150.statcan.gc.ca/n1/pub/82-625-x/2012001/article/11708-eng.htm
14. Poirier P et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss: an update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Circulation 2006; 113 (6): 898–918.
15. Emerging Risk Factors Collaboration et al. Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet Lond Engl 2011; 377 (9771): 1085–95.
16. Piché M-E, Poirier P, Lemieux I, Després J-P. Overview of Epidemiology and Contribution of Obesity and Body Fat Distribution to Cardiovascular Disease: An Update. Prog Cardiovasc Dis 2018; 61 (2): 103–13.
17. Tate RB, St John PD. Sudden Unexpected Cardiac Death on Monday in Younger and Older Men: The Manitoba Follow-up Study. Am J Epidemiol 2018; 187 (3): 633–5.
18. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67 (5): 968–77.
19. Plourde B, Sarrazin J-F, Nault I, Poirier P. Sudden cardiac death and obesity. Exp Rev Cardiovasc Ther 2014; 12 (9): 1099–10.
20. Poirier P et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation 2011; 123 (15): 1683–701.
21. Goossens GH. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function. Obes Facts 2017; 10 (3): 207–15.
22. Wajchenberg BL. Subcutaneous and Visceral Adipose Tissue: Their Relation to the Metabolic Syndrome. Endocr Rev 2000; 21 (6): 697–738.
23. Alexopoulos N, Katritsis D, Raggi P. Visceral adipose tissue as a source of inflammation and promoter of atherosclerosis. Atherosclerosis 2014; 233 (1): 104–12.
24. Britton KA, Massaro JM, Murabito JM et al. Body Fat Distribution, Incident Cardiovascular Disease, Cancer, and All-Cause Mortality. J Am Coll Cardiol 2013; 62 (10): 921–5.
25. General and abdominal obesity and abdominal visceral fat accumulation associated with coronary artery calcification in Korean men – ScienceDirect. https://www.sciencedirect.com/ science/article/pii/S0021915010005976
26. Ohashi N et al. Visceral fat accumulation as a predictor of coronary artery calcium as assessed by multislice computed tomography in Japanese patients. Atherosclerosis 2009; 202 (1): 192–9.
27. Imai A et al. Visceral abdominal fat accumulation predicts the progression of noncalcified coronary plaque. Atherosclerosis 2012; 222 (2): 524–9.
28. Lehman SJ, Massaro JM, Schlett CL et al. Peri-aortic fat, cardiovascular disease risk factors, and aortic calcification: the Framingham Heart Study. Atherosclerosis 2010; 210 (2): 656–61.
29. Britton KA et al. Prevalence, Distribution, and Risk Factor Correlates of High Thoracic Periaortic Fat in the Framingham Heart Study. J Am Heart Assoc 2012; 1 (6): e004200.
30. Fox CS et al. Periaortic fat deposition is associated with peripheral arterial disease: the Framingham heart study. Circ Cardiovasc Imaging 2010; 3 (5): 515–9.
31. Öhman MK et al. Perivascular Visceral Adipose Tissue Induces Atherosclerosis in Apolipoprotein E Deficient. Atherosclerosis 2011; 219 (1): 33–9.
32. Epicardial Adipose Tissue as a Predictor of Coronary Artery Disease in Asymptomatic Subjects – Science Direct. https://www.sciencedirect.com/science/article/pii/S0002914912011848
33. Alexopoulos N, McLean DS, Janik M et al. Epicardial adipose tissue and coronary artery plaque characteristics. Atherosclerosis 2010; 210 (1): 150–4.
34. Yun C-H et al. Pericardial and thoracic peri-aortic adipose tissues contribute to systemic inflammation and calcified coronary atherosclerosis independent of body fat composition, anthropometric measures and traditional cardiovascular risks. Eur J Radiol 2012; 81 (4): 749–56.
35. Yun C-H et al. The Normal Limits, Subclinical Significance, Related Metabolic Derangements and Distinct Biological Effects of Body Site-Specific Adiposity in Relatively Healthy Population. PLOS ONE 2013; 8 (4): e61997.
36. Nakanishi R et al. Increase in epicardial fat volume is associated with greater coronary artery calcification progression in subjects at intermediate risk by coronary calcium score: A serial study using non-contrast cardiac CT. Atherosclerosis 2011; 218 (2): 363–8.
37. Zairova AR et al. Arterial stiffness and vascular aging in relation to coalugogical CVD risk factors, parameters of lipid and carbohydrate metabolism in adult population of Tomsk in the framework of the project ESSE-RF. Kardiologicheskii Vestn. 2018; 13 (1): 5.
38. Liu H, Zhang X, Feng X et al. Effects of metabolic syndrome on cardio-ankle vascular index in middle-aged and elderly Chinese. Metab Syndr Relat Disord 2011; 9 (2): 105–10.
39. Satoh N et al. Evaluation of the cardio-ankle vascular index, a new indicator of arterial stiffness independent of blood pressure, in obesity and metabolic syndrome. Hypertens Res Off J Jpn Soc Hypertens 2008; 31 (10): 1921–30.
40. Gomez-Sanchez L et al. Association of metabolic syndrome and its components with arterial stiffness in Caucasian subjects of the MARK study: a cross-sectional trial. Cardiovasc Diabetol 2016; 15 (1): 148.
41. Homsi R et al. Epicardial Fat Volume and Aortic Stiffness in Healthy Individuals: A Quantitative Cardiac Magnetic Resonance Study. ROFO. Fortschr Geb Rontgenstr Nuklearmed 2016; 188 (9): 853–8.
42. Altun I et al. Increased Epicardial Fat Thickness Correlates with Aortic Stiffness and N-Terminal Pro-Brain Natriuretic Peptide Levels in Acute Ischemic Stroke Patients. Tex Heart Inst J 2016; 43 (3): 220–6.
43. Ohashi N, Ito C, Fujikawa R et al. The impact of visceral adipose tissue and high-molecular weight adiponectin on cardio-ankle vascular index in asymptomatic Japanese subjects. Metabolism 2009; 58 (7): 1023–9.
44. Park HE, Choi S-Y, Kim HS et al. Epicardial fat reflects arterial stiffness: assessment using 256-slice multidetector coronary computed tomography and cardio-ankle vascular index. J Atheroscler Thromb 2012; 19 (6): 570–6.
45. Strasser B, Arvandi M, Pasha EP et al. Abdominal obesity is associated with arterial stiffness in middle-aged adults. Nutr Metab Cardiovasc Dis 2015; 25 (5): 495–502.
46. Matthews DR, Hosker JP, Rudenski AS et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28 (7); 412–9.
47. Thanassoulis G et al. Prevalence, distribution, and risk factor correlates of high pericardial and intrathoracic fat depots in the Framingham heart study. Circ Cardiovasc Imaging 2010; 3 (5); 559–66.
48. Sarin S et al. Clinical significance of epicardial fat measured using cardiac multislice computed tomography. Am J Cardiol 2008; 102 (6): 767–71.
49. Takaki A et al. Cardio-ankle vascular index is superior to brachial-ankle pulse wave velocity as an index of arterial stiffness. Hypertens Res Off J Jpn Soc Hypertens 2008; 31 (7): 1347–55.
50. Tchernof A, Després J-P. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013; 93 (1): 359–404.
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Авторы
Е.А.Железнова1, Ю.В.Жернакова*1, И.Е.Чазова1, А.Н.Рогоза1, А.Р.Заирова1, М.А.Шария1, Е.Б.Яровая2, А.А.Орловский2, Н.В.Блинова1, М.О.Азимова1, Ш.Б.Гориева1, И.Д.Коносова1
1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а;
2 ФГБОУ ВО «Московский государственный университет им. М.В.Ломоносова». 119192, Россия, Москва, Ломоносовский пр., д. 31, корп. 5
*juli001@mail.ru
1 Clinical Cardiology National Medical Research Center of Cardiologyof the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
2 M.V.Lomonosov Moscow State University. 119192, Russian Federation, Moscow, Lomonosovskii pr., d. 31, korp. 5
*juli001@mail.ru
1 ФГБУ «Национальный медицинский исследовательский центр кардиологии» Минздрава России. 121552, Россия, Москва, ул. 3-я Черепковская, д. 15а;
2 ФГБОУ ВО «Московский государственный университет им. М.В.Ломоносова». 119192, Россия, Москва, Ломоносовский пр., д. 31, корп. 5
*juli001@mail.ru
________________________________________________
1 Clinical Cardiology National Medical Research Center of Cardiologyof the Ministry of Health of the Russian Federation. 121552, Russian Federation, Moscow, ul. 3-ia Cherepkovskaia, d. 15a
2 M.V.Lomonosov Moscow State University. 119192, Russian Federation, Moscow, Lomonosovskii pr., d. 31, korp. 5
*juli001@mail.ru
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