The Correlation Of Abdomen Intracavity Fat And Blood Lipid Level With Coronary Heart Disease

Objective: Nowadays many factors had been confirmed to be the risk factors of coronary heart disease (CHD) ,such as :age,sex,blood pressure ,dyslipidemia,smoking and diabetes and so on. Although unusual prevalence rate of blood lipid level of Chinese and dyslipidemia was still lower than many western countries,along with social economy's development, living standards' enhancement and life style's change, the crowd average blood serum total cholesterol level was elevating gradually. Then followed by all of these,there were also more and more over-weight and obesity. The epidemiology and the clinical research indicate obesity , especially abdomen obesity was the independent risk factor of heart and cerebrovascular disease. The reason caused abdomen obesity patients blood pressure raising up and metabolic disorder,was thought to have relation with abdomen fat over-deposition. CT may in the fine discrimination abdominal cavity subcutaneous fat and the abdominal cavity the fat, namely the visceral fat deposition. Through computing the rate of total abdominal adipose tissue and visceral adipose tissue may relate in coronary disease. On the other hand, although lipid metabolic disorder was a very important factor of diabetes metabolic disorder ,also had the close relation with coronary disease's occurrence, may provide the clinical prospective value compared with the TC/HDL-C ratio and the lipoprotein a single item inspection. This research was for the purpose of through applying the CT quantitative determination abdomen fat distribution, unifies the patient blood fats level, discusses its and coronary disease's relations.Methods: chosen 100 patients who were in hospital with chest pain,angina pectoris,myocardial infarction and had coronary angiography. Before the technique, the patient age,sex,body height, weight, waistline, hip circumference,hypertension and diabetes history were gathered. After the patient was hospitalized, the next morning the empty stomach extraction venous blood determination triglyceride, the total cholesterol, the high density lipoprotein cholesterol, the low density lipoprotein cholesterol, carry lipoprotein A, to carry lipoprotein B, lipoprotein A were took suction . Spiral CT of USA GE Company was used to scan the vertebral body of umbilical plane in breath holding state,measured visceral adipose tissue area (VTA) and total abdominal adipose tissue area (ATA), and VTA/ATA was calculated. All patients divided into two groups: CHD group,non-CHD group according to the result of coronary angiography. According to the lesion of coronary artery pathological of the blood vessel, CHD group was divided into two groups: one branch lesion group, multi-branch lesion group. Compared the difference with VTA/ATA between CHD group and non-CHD group .Compared the difference with two lesion change groups of blood vessel's between VTA/ATA, TC/HDL-C, lipoprotein A. Statistical analysis was done using Windows SPSS version 13.0J.Results:1 There was no significant difference in age , sex, smoking and BMI between patients of CHD group and non-CHD group (P>0.05). There was no significant difference at VTA,SA,ATA,VTA/ATA in the two groups of men and women when their BMI were same(P>0.05).2 Compared with non-CHD group,VTA and VTA/ATA in CHD group were significant elevated(P<0.05),but SA and ATA were no significant difference between the two groups (P>0.05).3 VTA/ATA, WC and implicate the coronary artery blood vessel degree relations: The VTA/ATA multi- pathological change group was higher than the single pathological change group, and between two groups had statistics significance (P<0.05).4 VTA and VTA/ATA were significant correlated positively with CHD. VTA/ATA≥0.44 was a predict factor of CHD .5 The rate of patients with VTA>100 cm2 of CHD was higher the rate of other people,and also significant difference (P<0.05).6 Surveys the VTA area through CT to forecast that coronary disease prevalence rate with through the waist measuring technique forecast coronary disease prevalence rate compares: The former coronary disease's prevalence rate high with the latter coronary disease's prevalence rate, and has statistics significance(P<0.05).7 VTA was significant correlated positively with TG,TC,LDL-c, Lp(a) and negatively with HDL-c (P<0.01).8 Compared with non-CHD group, TG,TC,LDL-c and LP(a) were significant elevated (P < 0.05),but apoA and apoB were no significant different(P>0.05);TC/HDL-c and LP(a) was no significant different between three groups of coronary artery lesion(P>0.05).9 VTA, SA, ATA and fat survey index relations: In the overall crowd, VTA, SA, ATA, and BMI, WC, WHR, SAD obviously were related, particularly had close relevance with WC.10 VTA/ATA was not significant correlated with WC(r=0.02, P>0.05), BMI(r=0.10, P>0.05),SAD(r=0.15, P>0.05)and WHR(r=0.08, P>0.05).Conclusions:1 Compared the measurement of VTA, ATA of abdomen fat through CT, with human body simple survey parameter BMI, WC, WHR, the SAD measurement, the CT measurement may appraise precisely obese, and may differentiate the abdomen intracavity fat and the subcutaneous fat.2 The CT measurement forecasted that coronary disease surpassed the conventional waist method forecast coronary disease obviously. The CT measurement may take the forecast coronary disease's target.3 Abdominal adipose was significant correlated with CHD,especially abdomen intracavity fat increased the incidence of coronary heart disease increased significantly. VTA/ATA≥0.44 may predict CHD.4 The distribution of abdominal adipose tissue is significant correlated with blood lipid. With the increasing of VTA,TG,TC,LDL-c and Lp(a) are rising significantly,and HDL-c is decreasing.