腹部内脏脂肪组织CT衰减与冠状动脉狭窄程度的相关性研究

Correlation Between CT Attenuation of Visceral Adipose Tissue and Degree of Coronary Artery Stenosis

目的:探讨冠心病患者腹部内脏脂肪组织CT衰减与冠状动脉狭窄程度的相关性。方法:收集2020年1月—2022年6月于徐州医科大学附属医院经冠状动脉CT血管成像(CCTA)诊断冠状动脉狭窄的患者197例,分析并记录患者的基本资料,利用腹部CT图像测量腹部内脏脂肪面积(VAT area)、腹部内脏脂肪CT衰减(VAT CT attenuation),腹部皮下脂肪面积(SAT area)、腹部皮下脂肪CT衰减(SAT CT attenuation),评估上述指标与患者临床资料及冠状动脉狭窄程度的相关性。结果:冠状动脉不同狭窄组比较发现,年龄、体重指数(BMI)、低密度脂蛋白胆固醇(LDL⁃C)、C反应蛋白(CRP)、糖尿病史、VAT area、VAT CT attenuation差异有统计学意义;对上述指标与冠状动脉狭窄程度进行Spearman相关性分析发现,冠状动脉狭窄程度与年龄、BMI、糖尿病史、VAT area均呈正相关,与VAT CT attenuation呈负相关。Logistic回归模型提示年龄、糖尿病及VAT area是冠状动脉中重度狭窄的独立危险因素,VAT CT attenuation是冠状动脉中重度狭窄的独立保护因素。对VAT area、VAT CT attenuation进行受试者工作特征(ROC)曲线分析发现,VAT area、VAT CT attenuation对冠状动脉中重度狭窄预测的曲线下面积分别是0.737、0.772,灵敏度分别为72.7%、75.8%,特异度分别为62.2%,63.3%。结论:VAT area、VAT CT attenuation能够从数量和质量两个方面较全面地评价腹部内脏脂肪,并且VAT area、VAT CT attenuation对冠状动脉中重度狭窄均具有一定的预测价值。

Purpose:To investigate the correlation between CT attenuation of abdominal visceral adipose tissue(VAT)and the degree of coronary artery stenosis in patients with coronary heart disease.Methods:One hundred and ninety-seven patients with coronary artery stenosis found by coronary computed tomography angiography(CCTA)in the Affiliated Hospital of Xuzhou Medical University from January 2020 to June 2022 were enrolled in this study.The basis data of the patients were analyzed and recorded.The abdominal CT images were used to measure the abdominal VAT area,VAT CT attenuation,subcutaneus adipose tissue area(SAT)area and SAT CT attenuation.The relationship between the above indicators and the general information,the degree of coronary artery stenosis was evaluated.Results:There were significant differences in age,body mass index(BMI),low density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP),diabetes history,VAT area and VAT CT attention between two coronary artery stenosis groups.Spearman correlation analysis of the above indicators and the degree of coronary artery stenosis showed that the degree of coronary artery stenosis was positively correlated with age,BMI,history of diabetes,and VAT area,and negatively correlated with VAT CT attention.Logistic regression model indicated that age,diabetes history and VAT area were independent risk factors for moderate-severe coronary artery stenosis,and VAT CT attenuation was independent protective factor for moderate-severe coronary artery stenosis.The receiver operating characteristic(ROC)curve analysis of VAT area and VAT CT attention showed that the areas under the curve of VAT area and VAT CT attention for the prediction of moderate and severe coronary artery stenosis were 0.737 and 0.772,respectively,with sensitivity of 72.7%and 75.8%and specificity of 62.2%and 63.3%,respectively.Conclusion:VAT area and VAT CT attention can be used to evaluate abdominal visceral adipose tissue in terms of quantity and quality,and both VAT area and VAT CT attention have certain predictive value for moderate and severe coronary artery stenosis.