Relationship between abdominal fat distribution and degree of coronary artery disease in patients with coronary heart disease / 中国实用护理杂志

ABSTRACT

0bjective The body mass index (BMI), waist to height ratio (RWH), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were used to measure the effect of abdominal fat distribution on the degree of coronary artery disease in patients with coronary heart disease. Methods A total of 376 patients with suspected coronary heart disease underwent coronary angiography. The degree of coronary artery disease was evaluated by Judkins method. The coronary artery stenosis ≥50% was coronary artery stenosis (coronary heart disease group), and the coronary artery diameter stenosis was <50% . For non-coronary stenosis (control group), the Gensini method was used to quantitatively evaluate coronary lesions, and the patient's height, body mass, waist circumference, blood lipids, blood pressure and other data were recorded, and BMI and RWH were calculated. All patients underwent upper abdominal CT examination. Measurement of VAT, SAT; Pearson correlation analysis of BMI, RWH, VAT/SAT and Gensini score correlation, multivariate Logistic regression analysis of BMI, RWH, VAT/SAT on coronary heart disease, stepwise linear regression analysis of BMI, RWH, VAT/SAT's impact on Gensini points. Results Of 376 patients with suspected coronary heart disease, 240 patients with coronary heart disease were diagnosed as coronary heart disease by coronary angiography, including 108 with single-vessel disease, 80 with double-vessel disease, 52 with three-vessel disease, and 136 with non-coronary heart disease. The systolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, low-density lipoprotein cholesterol, BMI, RWH, VAT/SAT, and Gensini scores in the coronary heart disease group were higher than those in the control group, and high-density lipoprotein cholesterol was lower than the control group (P<0.05). RWH, VAT/SAT and Gensini scores of patients with single-vessel disease, double-vessel disease and three-vessel disease gradually increased, and the difference between the two groups was statistically significant (P<0.05). The BMI of double-vessel disease and three-vessel disease patients was higher than that of patients with single-vessel disease (P<0.05). There was no significant difference in BMI between patients with double-vessel disease and three-vessel disease (P>0.05). The results of Pearson correlation analysis showed that Gensini score and RWH (r=0.838, P=0.023), VAT/SAT (r=0.892, P=0.001) had a significant positive correlation, which was related to BMI (r=0.651, P=0.328). Multivariate Logistic regression analysis showed that BMI>26 kg/m2 (OR=1.75, 95% CI 1.53-2.36, P=0.043), RWH>0.7 ( OR=2.81, 95% CI 1.39-5.67, P=0.015), VAT/SAT>0.6 ( OR=4.85, 95% CI 2.86-8.92, P=0.008) was a risk factor for coronary heart disease; stepwise multiple linear regression analysis showed that BMI had no significant effect on Gensini scores. RWH and VAT/SAT are the influencing factors of Gensini scores. The standardized regression coefficients were 0.368 and 0.796, respectively, and the effect is greater with VAT/SAT. Conclusions BMI, RWH, and VAT/SAT are elevated in patients with coronary heart disease. Compared with BMI, RWH and VAT/SAT can reflect the degree of coronary artery disease, and VAT/SAT has a greater impact on coronary artery disease.