内脏脂肪指数与冠心病及冠脉病变程度的关系

Association between visceral adiposity index and severity of coronary artery disease

目的探讨内脏脂肪指数(VAI)及其他肥胖指标与冠心病(CHD)及冠脉病变程度的关系。方法选择冠脉造影术证实有冠脉病变的患者133例(CHD组),按1∶2比例匹配年龄、性别,选取非冠心病患者266例为对照组,分析肥胖相关参数及VAI。以ROC曲线分析VAI等参数预测CHD的最佳切点及诊断价值。应用Pearson相关分析和条件logistic回归分析探讨各危险因素与冠脉病变程度的相关性及对CHD的风险。结果CHD组VAI明显高于对照组(P<0.01)。在总人群中VAI与腰围(WC)均可用于预测CHD,两者曲线下面积差异无统计学意义;以BMI为22.31 kg/m2为切点,而在正常偏瘦人群中,VAI与WC预测CHD效能更佳。条件logistic回归分析各肥胖指数及血脂等危险因素发现,VAI对CHD影响最大(OR=4.952),其次为WC和高密度脂蛋白胆固醇水平。而在行冠脉造影确诊CHD患者中,VAI值与描述冠脉病变严重程度的Gensini积分呈正相关(r=0.191,P<0.05)。结论 VAI是反映内脏性肥胖对CHD影响的较好测量指标,可应用于临床对CHD患者冠脉病变严重程度进行初步筛查与评估。

Objective To investigate the corelation between visceral adiposity index （VAI） and severity of coronary artery disease. Methods In case group, 133 coronary heart disease（CHD） patients were diagnosed by coronary angiography, while 266 age and gender matched controls were selected as control group. Pearson＇s correlation coefficient, logistic regressions and receiver operating characteristic （ROC） curve were used to analyze the correlations among CHD and different obese indexes, including, VAI and waist circumference （WC）. Results Compare with control group, VAI were significantly increased in CHD group （P 〈0. 01 ）. ROC curve suggested that VAI and WC were useful in predicting CHD （0. 673 and 0. 667 ） , especially in lean subjects （0. 755 and 0. 741 ）. The adjusted odds ratios of CHD associated with VAI, WC, and HDL - C were 4. 952, 4. 744 and 4. 385, respectively. In CHD group, VAI was significantly positively correlated with Gensini scroe （ r = 0. 191, P 〈 0. 05 ）. Conclusion VAI, as a new factor representing visceral obesity, is a good predictor for CHD.