Correlation Of Waist Circumference In Women Population And Fibroblast Growth Factor21to Atherosclerosis

Part I: Impact of waist circumference on carotid intima mediathickness in women populationObjectiveVisceral obesity is related to a series of cardiovascular and metabolic diseases. Wehave defined the optimal cutoff of waist circumference (W) over85cm for visceralobesity, which was found to be more capable in predicting future CVD events inwomen. We aimed to evaluate whether W over85cm is related to asymptomaticpre-clinical atherosclerosis in Chinese women.Materials and MethodsWomen individuals (N=2365, aged20and over) from four communities inShanghai China received a series of physical examinations, including evaluation ofwaist circumference and carotid artery scanning was performed for measurement ofcarotid intima-media thickness (C-IMT).ResultsC-IMT was found to be significantly higher in overweight or obese women (bodymass index, BMI≥25.0kg/m2, P <0.01) and those with W over85cm hadsignificantly higher C-IMT level compared to those with W less than85cm (P <0.01). Spearman correlation analysis showed significant positive correlations of C-IMT withW. C-IMT was significantly elevated with the increase of W and reached to a platformin about85cm. There existed an increment tendency in subgroup of W less than85cm(P for trend <0.01) while no significant tendency in subgroup of W over85cm wasfound (P for trend=0.07). Stepwise regression analysis showed that W was one of theindependent factors of C-IMT (β=0.106, P=0.014) and multivariate logisticregression analysis also showed that central obesity defined by W over85cm was oneof the independent risk factors of the elevation of C-IMT (OR=1.346,95%confidence interval:1.092-1.658, P <0.01).ConclusionWaist circumference is significant in correlation with C-IMT in Chinese womenand W over85cm was capable in predicting the risk of sub-clinic carotidatherosclerosis. Part II: Additive relationship between fibroblast growth factor21and coronary artery diseaseObjectiveThe circulating fibroblast growth factor (FGF)21is primarily synthesized by theliver, but plays an important systemic role in regulating glucolipid metabolism andinsulin sensitivity with its expression and activity associated with development ofseveral metabolic disorders. This study was designed to investigate whether serumFGF21level was also associated with the metabolic syndrome-related cardiovasculardisease, atherosclerosis, and its clinical features in a Chinese cohort.Materials and MethodsA total of253subjects aged38-86years old visiting the Cardiology Department(Shanghai JiaoTong University affiliated Sixth People’s Hospital) were examined bycoronary arteriography to diagnose coronary artery disease (CAD) and hepaticultrasonography to diagnose non-alcoholic fatty liver disease (NAFLD).ResultsSerum FGF21level was measured by enzyme-linked immunosorbent assay andanalyzed for correlation to subject and clinical characteristics. The independentfactors of CAD were determined by multivariate logistic regression analysis. Wefound that subjects with NAFLD showed significantly higher serum FGF21thanthose without NAFLD (388.0pg/mL (253.0-655.4) vs.273.3pg/mL (164.9-383.7), P<0.01). Subjects with CAD showed significantly higher serum FGF21, regardless ofNAFLD diagnosis (P <0.05). Trend analysis showed that serum FGF21levelsignificantly elevated with the increasing number of metabolic disorders (P for trend<0.01). After adjustment of age, sex, and BMI, partial correlation analysis showedthat FGF21was positively correlated with total cholesterol (P <0.05) and triglyceride(P <0.01). In a logistic regression model, FGF21was identified as an independent factor of CAD (OR=2.984,95%confidence interval:1.014-8.786, P <0.05).ConclusionWe concluded that increased level of serum FGF21is associated with NAFLD,metabolic disorders and CAD. FGF21is one of the independent risk factors of CADregardless of the diagnosis of NAFLD.