title: Importance of intra-abdominal visceral fat accumulation to coronary atherosclerosis in heterozygous familial hypercholesterolaemia.
abstract: OBJECTIVE
  Hyper-low-density lipoprotein (LDL)-cholesterolaemia is a potent risk factor for coronary atherosclerosis. We have recently demonstrated that a cluster of risk factors including insulin resistance, glucose intolerance, hypertriglyceridaemia, and hypertension based on intra-abdominal visceral fat accumulation are closely related to coronary artery disease. In the current study, we evaluated the relationship between visceral fat accumulation and the severity and distribution of coronary atherosclerosis in familial hypercholesterolaemia (FH).
  
  
  METHODS
  The effect of visceral fat accumulation on coronary lesions and risk factors in patients with FH was investigated.
  
  
  METHODS
  Thirty-one male patients with heterozygous FH who underwent coronary angiography.
  
  
  METHODS
  Abdominal fat distribution was estimated by a cross-sectional computed tomographic scan at the umbilical level. Plasma lipid, glucose and insulin concentrations and blood pressure were measured. A 75 g oral glucose tolerance test was also performed.
  
  
  RESULTS
  The patients were divided into two groups according to the degree of visceral fat accumulation. Fifteen patients had high visceral fat accumulation (High VF group) and 16 patients had normal visceral fat accumulation (Normal VF group). Body mass index (BMI) and subcutaneous fat area were significantly higher in the high VF group. Baseline serum triglyceride was significantly higher and baseline low-density lipoprotein (LDL)-cholesterol and reduction of LDL-cholesterol during treatment were significantly lower in High VF group. Fasting plasma glucose and insulin concentrations, and systolic and diastolic pressures were significantly higher in the High VF group. Significant correlations were found between visceral fat area and the sum of the glucose and insulin concentration during an oral glucose tolerance test. Visceral fat area was significantly correlated with the severity of coronary stenosis index. Distal coronary lesions were significantly more frequent in the High VF group. Moreover, the correlation between the visceral fat area and coronary stenosis index was found to be independent of age, BMI, and subcutaneous fat area by multiple regression analysis.
  
  
  CONCLUSIONS
  Visceral fat accumulation is a potent cardiovascular risk factor in heterozygous FH.
authors.affiliation: Second Department of Internal Medicine, Osaka University Medical School, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Kobayashi
authors.forename: K
authors.initials: K
authors.lastname: Yanagi
authors.forename: T
authors.initials: T
authors.lastname: Nakagawa
authors.forename: M
authors.initials: M
authors.lastname: Nishida
authors.forename: S
authors.initials: S
authors.lastname: Kihara
authors.forename: H
authors.initials: H
authors.lastname: Hiraoka
authors.forename: S
authors.initials: S
authors.lastname: Nozaki
authors.forename: T
authors.initials: T
authors.lastname: Funahashi
authors.forename: S
authors.initials: S
authors.lastname: Yamashita
authors.forename: K
authors.initials: K
authors.lastname: Kameda-Takemura
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D000005:Abdomen; D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D001824:Body Constitution; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003324:Coronary Artery Disease / Q000209:etiology*; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D002784:Cholesterol