The Research Of Correlation Between Visceral Adipose Tissue Distribution And High-sensitivity C-Reactive Protein On The Patients Of Coronary Atherosclerotic Heart Disease

Objective: The mechanism of coronary heart disease (CHD) is not clearuntil now, but studies resent years have show that it is an inflammatorydisease arising from endothelial dysfunction. A wide range of inflammatorycytokines such as C-reactive protein and interleukin-6(IL-6) play animportant role in the initiate and progression of CHD. As the importantposition in etiologist, Obesity is more and more thought highly by studiers.Obesity is intimately associated with traditional risk factors of CHD, such asinsulin resistance, hypertension, dyslipidemia and impaired glucosemetabolism. Recent studies in the biology of adipose tissue have confirmedthat adipose tissue especially visceral adipose tissue is not simply an energystorage organ but also secretes many of adipokines and bioactive mediatorswhich lead to a chronic state of inflammation and an increased risk ofcardiovascular disease (CVD).C-reactive protein is an acute phase reactant which is mainly producedby liver in response to microbial infection and tissue injury. Many ofcase-control and prospective studies have show that high-sensitivity c-reactiveprotein (hs-CRP) is able to predict risk for CVD in various populations.Moreover, hs-CRP level is closely linked to the severity of coronarypathological changes and course of CHD prognosis. Other studies considerthat hs-CRP may be favoring the cascade of atherosclerotic plaque initiation，development and rupture. So hs-CRP has been suggested to be the mostpowerful inflammatory maker of CHD.The close relationship between hs-CRP and Obesity has been confirmedin some investigations. It has been reported that IL-6and TNF-α are increasedin obesity and they can stimulate the liver production of hs-CRP. Moreover, about30%of total circulating concentrations of IL-6originate from adiposetissue in healthy subjects. Those above all suggest that adipose tissue alsoregulates the concentrations of hs-CRP. Post studies mostly used simpleanthropometrically measurements such as body mass index (BMI), waistcircumference (WC). Moreover, the subjects were mostly chosen fromhealth and metabolic syndrome. The study about the correlation betweenhs-CRP and abdomen visceral adipose tissue accumulation of CHD(stableangina pectoris) patients was small. Investigating the relationship of hs-CRPand abdomen visceral adipose tissue measured through computerizedtomography (CT) is the main target in our study. Then the study will providefoundation to elevate the pathogenicity of visceral adipose tissue, to provideevidence for the mechanism of CHD and to treat and predict clinically.Methods: Subjects were chosen from Cardiology Department of HebeiMedical University Second Hospital. The entry criterion of our study was thecriteria for CHD (stable angina pectoris) in1979of WHO. All subjects werestrictly in accordance with the entry and exclusion criteria. Their treatmenttime was from November1st,2010to December1st,2011. Total number ofsubjects was82, among them female was39, male was43. After admission,we recorded their age and sex firstly; secondly, we used standard method torecord their weight, height, WC, hip circumference and blood pressure; thirdly,the fasting hs-CRP and blood glucose check were made; finally, theabdominal CT scanning was conducted to calculate visceral adipose(VA) andsubcutaneous adipose(SA). Based on the above data, the BMI, waist to hipradio (WHR) were calculated. According to VA≥100cm2, all the clinical andbiochemical data were divided into the two groups of high VA group andnormal VA group.The clinical and biochemical data of subjects are presented as mean±standard deviation, median for variables with a skewed distribution. Theclinical and biochemical data of subjects between two groups were comparedthrough t test, or through the Mann-Whitney U test for skewed distributionvariables. The concentrations of hs-CRP were logarithmically transformed, because it was a skewed distribution. Analysis of relationship between clinicaldata and logarithmically transformed hs-CRP was conducted by multiplelinear regression analysis. In our study, SPSS13.0program was used toconduct statistical analyses.Result: Data of high VA group: age59.55±8.51, systolic pressure139.53±15.36, diastolic pressure86.78±9.72, blood glucose5.37±0.69, BMI28.23±2.04, WC90.90±5.49, WHR0.96±0.06, VA126.11±19.28, SA176.16±22.06, hs-CRP2.70; and data of normal VA group: age60.48±9.09,systolic pressure133.10±14.08, diastolic pressure82.94±7.28, blood glucose5.10±0.65, BMI24.46±1.68, WC81.52±3.92, WHR0.87±0.06, VA80.93±16.81, SA148.03±21.28, hs-CRP1.25. Among above data, age,systolic pressure, diastolic pressure and blood glucose were no significantdifference between two groups (P>0.05). However, data of high VA groupwere larger than data of normal VA group on hs-CRP, VA, SA, WHR, BMIand WC (P<0.01). The multiple linear regression analysis which reflectedcorrelation between clinical data and logarithmically transformed hs-CRPindicated that the influencing factors with liner regression were VA、WC、WHR、BMI, but not SA. The standardized regression coefficient in the orderof descending were VA0.321(P=0.003), WC0.209(P=0.044), WHR0.198(P=0.009), BMI0.191(P=0.048), SA0.091(P=0.209).Conclusion: Among above data, parameters of high VA group werelarger than data of normal VA group on hs-CRP, VA, SA, WHR, BMI andWC (P<0.01). From this we can believe that patients of same age with CHDwho have more visceral adipose will have higher concentrations of hs-CRP.The multiple linear regression analysis indicated that BMI, WHR, WC andVA were all the factors impacting on the concentrations of hs-CRP, and theVA measured from CT was the strongest one. So we can conclude thaths-CRP level is closely linked to obesity especially visceral fat depots inCHD.