| Objective:To investigate the association between distribution of body fat and coronary heart disease (CHD) by analysing the correlation between body fat distribution measures and incidence, type and severity of coronary heart disease. To investigate the association between distribution of body fat and coronary heart disease (CHD) by analysing the correlation between body fat distribution measures and incidence, type and severity of coronary heart disease.Methods:One hundred and ninety-seven patients(male 118 and female 79) with suspected coronary heart disease were studied by the case-contral method, who were divided into acute infarction (AMI) group (n=52),angina group (n=100) and non-CHD group(n=45); and according to the results of coronary arteriography they were divided into:normal group(n=45),Single-vessel disease group(n=48) double -vessel disease group(n=51) and triple-vessel disease group(n=53). One hundred and one cases were randomly divided into 3 groups,standard combined treatment group(n=24,atorvastatin 20 mg,1 time/d and probucol 500 mg,2 times/d;intensively combined treatment group(n=38,atorvastatin 40 mg,l time/d,and probucol 500 mg,2 times/d,intaking bolus of atorvastatin 40 mg and probucol 500 mg 2 hours before intervention;intensive atorvastatin therapy group(n=39,atorvastatin 40 mg,1 time/d,bolus intaking atorvastatin 40 mg 2hours before procedure.Blood lipids were detected by the standard method, Keep the serum at the same time then matrix metalloproteinases-9(MMP-9),myeloperoxidase(MPO) and oxidized low density(ox-LDL) were measured by enzyme immunoassay kit. Body surveying index consisting of the patients' height, weight, neck circumference and waist circumference was measured and body mass index(BMI)were computed. Analysis the correlation between body fat distribution measures and incidence, type and severity of coronary heart disease.CHD risk factors were collected by logistic multivariate regression analysis.Results:1 Male and female have different features in distribution of body fat,and CHD has different characteristic in them (p<0.05)2 Compared with non-CHD group and angina groups, weight and waist circumference were higher in AMI group(p<0.05). Compared with non-CHD group, neck circumference were higher in angina and AMI groups (p=0.009&0.000) 3 In the four groups divided by vessel disease, there were significant difference in neck circumference (p=0.014), compared with double and triple vessel disease groups neck circumference were lower in single-vessel disease group (p=0.011&0.002)4 Multiple correlative analysis showed BMI,NC and WC were positively correlated with TG and vLDLc, WC was also correlated withchd and HDLc(p<0.05), NC was positively correlated with type coronary heart disease and the number of diseased vessels(p=0.000&0.002).5 Logistic multivariate analysis indicated that BMI (beta=0.162, p=0.003); NC (beta=0.222,p=0.000), diabetes (beta=1.154, p=0.047) were closely related to the hazard of CHD.6 Post/pre-PCI remainder of CK-MB in intensively combined treatment group is less than that in standard combined treatment group(p=0.032). There were statistically differences of post/pre-operative remainder of TnI among the three groups, and the difference in intensively combined treatment group is less than that in other two groups (p=0.048&0.023)7 The values of serum lipid profile are lower after PCI in all three groups, but there was no statistically differences of post/pre-PCI remainder of serum lipid profile among the three groups.8 The level of MMP-9 raised after PCI in intensive atorvastatin therapy group(p=0.026); The level of ox-LDL and MPO are lower than pre-PCI in intensively combined treatment group after PCI (p=0.008);post/pre-PCI remainder of MPO in intensively combined treatment group is less than that in the other groups (p=0.023&0.033)Conclusions:1 The associations with lipid were stronger for BMI and waist circumference than it for neck circumference;2 Compared with WC and BMI, neck circumference offered greater sensitivity for the diagnosis in coronary artery disease,and associated with the number of diseased vessels;3 BMI and NC were important risk factors of coronary artery disease; 4 Distribution and Content of fat should be comprehensively evaluated by various body fat distribution measures, so that risk evaluation of CHD can be provided;5 The intensively combined treatment of atorvastatin and probucol before percutaneous coronary intervention significantly reduces procedural myocardial injury in elective PCI, this protective effect is independent of lipid decreasing, the possible mechanism is reducing inflammation and oxidative stress reaction, and improving the microcirculation. |
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