The Study On Relationship Between The Severity Of Coronary Artery Stenosis And The Abdominal Adipose Index In The Patients Of Coronary Heart Disease Complicated With Metabolic Syndrome

Objective: Along with life style's transformation, the amount of over-weight and obesity is increasing rapidly, what is following is Metabolic Syndrome (MS) and Coronary Heart Disease (CHD) comes, and the disease incidence rate and the mortality rate rises year by year. But the MS does for the high-risk factor of CHD, in recent years became the research's focus gradually. When CHD patient complicated with MS, the mortality will increase obviously. More and more researches indicated abdominal obesity will increasing prevalence of CHD. The most important part of MS is abdominal obesity which ascribe to abdominal adipose distribution. The CT technology is the best method to measure the distribution human body adipose tissue. Through using some software can measured Visceral adipose tissue area (VA), total abdominal adipose tissue area (TA), and may calculate abdominal adipose index (VA/TA). The coronary artery angiography (CAG) is the coronary artery disease diagnosis golden standard. The severity of CHD is quantified by a modified Gensini score. The purpose is to observe the relationship between CHD and MS and the abdominal adipose index in the patients, as well as the feasibility of applying VA/TA to predict CHD.Methods: 75 patients (male 45 and female 30, age 37-75 years old, average 56.17±8.23 years old) with chest pain, angina pectoris and myocardial infarction who diagnosed CHD by coronary angiography were enrolled in the study. The severities of coronary artery stenosis were evaluated by Gensini score. Refering to IDF diagnostic criteria, the patients were divided into two groups: CHD with MS group(A group,n=35)and CHD without MS group(B group, n=40). The patient's systolic blood pressure (SBP), diastolic blood pressure (DBP), Body Mass Index (BMI)I and Waist circumference(WC) were measure when they enrolled in the hospital. Patients'preprandial blood was exam by routine assay, including Triglyceride (TG), Total cholesterol (TC), High-density lipoprotein cholesterol (HDL-c), Low-density lipoprotein cholesterol(LDL-c),Fasting plasma glucose(FPG) at the next day. 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 (VA) and total abdomen adipose tissue area (TA), and VA/TA was calculated. Statistical analysis was done using Windows SPSS version 13.0J. Numerical values are shown as means±SD. Group comparisons used t-test, correlation analysis used partial correlation logistic regression analysis. P<0.05 for the difference is remarkble statistical significance.Results:1 There was no significant different in aging, sex and BMI between patients of CHD with MS group and CHD without MS group (P>0.05), but the WC in the MS group significant elevated than non-MS group.2 Compared with CHD without MS group, VA and VA/TA were significant elevated(P<0.05).3 VA and VA/TA were significant correlated positively with CHD. VA/TA≥0.44 can predict CHD is rising.4 Compared with CHD without MS group, TG, LDL-c, SBP, FPG were significant elevated (P<0.05), HDL-c was significant reduced (P<0.05).5 Compared with CHD without MS group, Gensini score were significant elevated (P<0.05).6 VA/TA was significant correlated positively with Gensini score(r=0.73, P<0.01).7 VA/TA was significant correlated positively with TG(r=0.75, P<0.01), TC(r=0.79, P<0.01), LDL-c(r=0.84, P<0.01), SBP(r=0.66, P<0.01), DBP(r=0.44, P<0.01), FPG(r=0.73, P<0.01), HDL-c(r=-0.74, P<0.01). Conclusions: 1. The elements of MS are significant correlated with CHD. The Gensini score in CHD with MS group is higher than CHD without MS group. 2. The distribution of abdominal adipose tissue is significant correlated with MS. With the increasing of TG, LDL-c, SBP, FPG and VA/TA are rising significantly, and with the HDL-c decreasing, VA/TA is rising significantly. The VA/TA in CHD with MS group is higher than CHD without MS group. 3. The distribution of abdominal adipose tissue is significant correlated with CHD, with the increasing of VA/TA, the Gensini score are rising significantly. VA/TA and the Gensini score in CHD with MS group are higher than CHD without MS group. 4. The distribution of abdominal adipose tissue is significant correlated with CHD, VA/TA≥0.44 can predict CHD. It can be used in clinic.