Correlation between visceral fat and coronary artery calcium in metabolic syndrome patients

초록

Background and Aims: To assess the relationship between visceral fat (VF) and coronary artery calcium (CAC), we performed visceral fat scan and coronary CT angiography (CCTA) in metabolic syndrome (MetS) cohort. Methods: From January to September 2014, among 1000 MetS patients who were referred from 24 public health centers in Seoul, 740 patients who performed visceral fat scan (HDS-2000, Omron) were enrolled in this analysis. MetS was defined as any three of the following traits in one individual: abdominal obesity (Men>90cm, Women>85cm), high triglycerides(TG) (>150mg/dL), low high-density lipoprotein cholesterol (HDLc) (Men<40mg/dL, Women<50mg/dL, hypertension (>130/85mmHg), and high fasting glucose levels (>100mg/dL) in each public health centers. Fatty liver grade were measured from 0 to 3 by ultrasound. Brachial ankle pulse wave velocity (PWV), carotid intima-media thickness (IMT), Left ventricular mass index (LVMI) and Augmentation index (AIx) were also measured. We also measured CAC using CCTA. Results: The cut-off value of high VF area was calculated 88cm2 by Youden index. Incidence of MetS patients who had high VF area (≥88cm2) was 36% (267/740) and the prevalence of men was higher than women (53.4% vs 18.7%, p<0.001). High VF group showed higher CAC than normal VF (11.2±43 vs 25.6±95, p=0.025). The VF showed positive correlation with PWV and IMT (p=0.028, 0.019). LVMI, CAC, abdominal subcutaneous fat, fatty liver grade, serum glucose, TG, HDLc, TG/HDLc ratio, systolic and diastolic blood pressure were also positively correlated with VF (all of the p < 0.01). Conclusions: High VF group showed high CAC. Moreover, VF area had shown correlation with PWV, IMT, LVMI, CAC, TG/HDLc ratio, abdominal obesity, fatty liver grade and abdominal subcutaneous fat in MetS cohort. It may be considered that the VF could predict severity of CAC, arterial stiffness, atherosclerosis, insulin resistance and fatty liver in MetS.