The Correlation Between Visceral Fat Distribution And Carotid Atherosclerosis In Hypertension

Objective:Atherosclerosis is one of the most common vascular diseases of arteriosclerosis. Its characteristic is the form of the plaque of arterial intima. Atherosclerosis involves in the accumulation of lipids and complex carbohy–drates,fibrous tissue hyperplasia,calcinosis and a gradual transformation and the middle artery calcification. The large and medium of muscular arteries and flexibility arteries are often suffered. The plaque suddenly ruptures which leads to hemorrhage and thrombosis. As a result , the tissue or organ may be ischemia or necrosis. The most important causes of atherosclerosis include hy -pertension, diabetes, hyperlipidemia, smoking, obesity, and old age. More -over,lack of exercise, stress status, and family history may be involved.In patients with obesity, especially abdominal obesity, fat tissue lying in the abdominal can secrete many hormones, cytokines, etc, which lead to insulin resistance, hyperinsulinemia, hypertension, hyperlipidemia, and so on .These risk factors interact with one another which can result in formation and development of atherosclerosis . Body mass index (BMI), waist circumf -erence (WC), waist-hip ratio (WHR) and waist to height ratio (WHtR) are commonly used to assess obesity. However BMI of many atheroma patients are in the normal range. So these atheroma patients may be neglected. Some studies have shown that different adipose tissue have different effects on the risk factors for metabolic diseases. Visceral fat may be the only pathogenic adipose tissue. Recently, the focus of the study in obesity and its complica -tions has been transferred to the human adipose tissue (AT) distribution, rather than overall degree of obesity. Computerized Tomography (CT) technology provides a more direct way to accurately measure human obesity and whole body AT volume, especially the regional AT, such as subcutaneous or visceral fat. Recently,some studies have found that carotid artery is the window of reflecting atherosclerosis of body. Carotid artery high-frequency Doppler ultrasound examination is a good non-invasive method which is intuitive and accurate.It can measure carotid artery wall and determine the degree of ather -osclerosis. Obesity is a risk factor of atherosclerosis which has been widely accepted.However, there are few detailed reports about the association betwe -en the abdominal fat distribution and atherosclerosis. So our study aims to analyze the correlation between ratio of visceral adipose tissue and subcut -aneous adipose tissue (VAT/SVT, V/s) and the degree of atherosclerosis. We futher investigate whether V/s is a available indicator for predicting the degree of atherosclerosis.Methods: one handred participants (79 males, 21 females) were drawn from the Cardiology Department of Hebei Medical University Second Hospital from March to October 2009, diagnosed as hypertension, accepted the underwent abdominal multi detector computed tomography assessment of SAT and VAT volumes.Then the Subjects accepted Bilateral carotid artery ultrasound examination, measuring carotid artery intima-media thickness and count the number of carotid artery plaque, using Crouse integral method for its integral. Then measured and calculated BMI, WC, WHR, WHtR and V / s of subjects.Then according to the results of carotid artery ultrasound, IMT> 1mm divided into atheroscler -osis group and non-atherosclerotic groupAll statistical analyses were performed using the SPSS 11.5 program package. Data were expressed as the mean value±standard deviation. Data between two groups were compared by t test. Analysis of risk factors was performed by multivariate linear stepwise regression analysis . P value of less than 0.05 was considered to be statistically significant.Results:1 According to the results of carotid artery ultrasound ,intima -media thickness (IMT) which is greater than 1mm is divided into atherosclerosis group and non-atherosclerotic group, and compare each parameter between the two groups:Non-atherosclerotic group (group 1) 45 cases, atherosclerosis group (group 2) 55 cases ,average age (57.51±6.46, 62.18±6.54) years. Blood pressure and duration of hypertension between the two groups was not statistically significant difference (P> 0.05), while BMI, WC, WHR, WHtR, V / s, age 2 group was higher than group 1 (P <0.05)).2,Take the the carotid artery plaque score as the dependent variable, and age, BMI, WC, WHR, WHtR and V/s as independent variable, the line multivariate linear stepwise regression analysis showed that V/s , WC, WHR, and age with carotid artery plaque score had a linear regression relationship, standardization regression coefficient were 0.401,0.198,0.196,0.164 (P <0.05), other factors did not reveal the relationship, suggesting that above all factors V/s had the greatest impact in carotid atherosclerosis.Conclusion:According to the results of carotid artery ultrasound intima-media thickness (IMT)which is greater than 1mm is divided into atherosclerosis group and non-atherosclerotic group, and compare each parameter between the two groups. We found that atherosclerosis group were higher than non-atheros -clerotic group in age, BMI,WC,WHR,WHtR and V/s. Take the the carotid artery plaque score as the dependent variable, and age, BMI, WC, WHR, WHtR and V/s as independent variable, the line multivariate linear stepwise regression analysis showed that V/s , WC, WHR, and age with carotid artery plaque score had a linear regression relationship which suggested that above all factors of reflecting the distribution of abdominal visceral fat V/s had the greatest impact in carotid atheroscler–osis.