Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men

Nakamura, Tadashi; Tokunaga, Katsuto; Shimomura, Iichiro; Nishida, Makoto; Yoshida, Shingo; Kotani, Kazuaki; Islam, Abdul Hasan M. Waliul; Keno, Yoshiaki; Kobatake, Takashi; Nagai, Yoshiyuki; Fujioka, S; Tarui, Seiichiro; Matsuzawa, Yūji

doi:10.1016/0021-9150(94)90025-6

Cited by 381 publications

(231 citation statements)

References 31 publications

Supporting

Mentioning

217

Contrasting

Unclassified

Order By: Relevance

“…Subjects with a visceral fat area more than 100 cm 2 have been shown to have more obesity-related diseases than obese individuals without visceral fat accumulation. 10 From these clinical studies, we proposed a disease entity named 'visceral fat syndrome,' which is similar to the syndrome X proposed by Professor Reaven 11 and the deadly quartet proposed by Professor Kaplan. 12 The concept of the metabolic syndrome has become well established as a highly atherogenic state in which insulin resistance, hyperglycemia, hypertension and lipid disorders cluster.…”

Section: Visceral Fat Analysis and Its Clinical Significancementioning

confidence: 89%

The role of fat topology in the risk of disease

Matsuzawa

2008

Int J Obes

105

View full text Add to dashboard Cite

Clustering of multiple risk factors such as impaired glucose metabolism, lipid disorders and hypertension has been shown to be the major background of atherosclerotic diseases, and disease entities such as the metabolic syndrome represent a highly atherogenic state. Although these common risks may generally co-exist by accident in one individual, clustering of multiple risk factors in the metabolic syndrome does not occur by accident, and there should be a key player for the syndrome. In 1983, we reported the method for fat analysis using computed tomography scan, which enables us to analyze intra-abdominal visceral adiposity as well as subcutaneous fat. Visceral fat accumulation has been shown to cause impaired glucose metabolism, lipid disorders, and hypertension, and therefore it is considered to be a key player in the metabolic syndrome. To clarify the mechanism by which visceral fat accumulation causes a variety of metabolic and vascular diseases, we studied the molecular characteristics of adipose tissue and adipocytes by investigating expressed genes in visceral and subcutaneous adipocytes and revealed that adipocytes, especially visceral adipocytes, secrete a variety of bioactive substances, the so-called adipocytokines. We showed that visceral fat accumulation causes abnormalities in adipocytokine secretion, such as hypersecretion of plasminogen activator inhibitor 1, which is related to thrombogenic vascular diseases. More importantly, we discovered an important benign adipocytokine named adiponectin, which protects against the development of diabetes mellitus, hypertension, inflammation, and atherosclerotic vascular diseases. Plasma levels of adiponectin decreased in individuals with visceral fat accumulation, and hypoadiponectinemia caused by visceral fat accumulation might be one of the major causes of metabolic syndrome.

show abstract

Section: Visceral Fat Analysis and Its Clinical Significancementioning

confidence: 89%

The role of fat topology in the risk of disease

Matsuzawa

2008

Int J Obes

105

View full text Add to dashboard Cite

show abstract

“…The incidence of cardiovascular disease is high even in non-obese individuals with a BMI within the normal range who have an accumulation of visceral fat. 21 Recently, VFA has been significantly associated with insulin resistance 22 and with the prevalence of CVD in participants from the Framingham Heart Study; 23 thus, the accurate assessment of both body fat distribution and VFA is critical for assessing the risk of arteriosclerotic disease. Ohkawa et al 24 reported that VFA in hemodialysis patients increased irrespective of BMI, and a positive relationship existed between VFA and atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Potential impact of renin–angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients

Nakagawa

Yao²,

Hirayama³

et al. 2011

Hypertens Res

View full text Add to dashboard Cite

Although metabolic syndrome confers an increased risk of cardiovascular disease in the general population, little is known about the alteration of abdominal adiposity and its association with adipocytokines in hemodialysis patients. We investigated the plasma high-molecular-weight (HMW) adiponectin level and its relationship to visceral fat area (VFA) and various markers of atherosclerosis in hemodialysis patients. In a cross-sectional study, conventional cardiovascular risk factors, plasma total and HMW adiponectin, the number of components of the metabolic syndrome and, using computed tomography, the distribution of abdominal adiposity were assessed in 144 hemodialysis patients (90 men and 54 women; mean age, 60.7 years) and 30 age-and sex-matched patients with chronic kidney disease (CKD). Plasma HMW adiponectin levels in hemodialysis patients were significantly higher than those in patients with CKD, negatively associated with VFA and serum triglycerides and positively associated with plasma total adiponectin, as well as the HMW-to-total adiponectin ratio in men and women (all Po0.05) in a simple regression analysis. In a multiple regression analysis, VFA was a significant determinant of HMW adiponectin in hemodialysis patients. Furthermore, after adjustment for classical risk factors, HMW adiponectin levels were significantly higher in patients undergoing treatment with renin-angiotensin system inhibitors or calcium channel blockers compared with patients not undergoing such treatment. This study shows that plasma HMW adiponectin levels were negatively associated with VFA and positively associated with treatment with blockade of the renin-angiotensin system and of the calcium channel. Therefore, these drugs might be effective for improving adipocytokine-related metabolic abnormalities in hemodialysis patients.

show abstract

“…Furthermore, there is increasing evidence that the mass and distribution of adipose tissue, rather than the relatively crude estimates of adipose tissue obtained by measuring the BMI or waist circumference, may more accurately reflect the risk of developing the metabolic syndrome and cardiovascular disease. 36,37 The main limitation of this study is the cross-sectional design and longitudinal studies are required to validate the diagnostic usefulness of adiponectin and other adipokines for the detection of subjects at risk of developing the metabolic syndrome. Another potential limitation is the fact that adiponectin circulates in different forms with different states of oligomerization and glycosylation that may have functional consequences.…”

Section: Discussionmentioning

confidence: 99%

Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes

et al. 2006

View full text Add to dashboard Cite

Background: Obesity and the metabolic syndrome have emerged as clinical and public health crises in many populations, but not all obese patients have the syndrome. As adipocytes produce several adipokines that modulate insulin action as well as glucose and lipid metabolism, we postulate that estimation of adipokines may be useful addition to the criteria used to identify obese individuals with the metabolic syndrome. Objective: To evaluate the determinants and associations of plasma adiponectin in relation to the metabolic syndrome in patients with Type 2 diabetes. Design: Cross-sectional study. Setting: General Teaching Hospital. Patients: One hundred and thirty five (57 M, 78 F) patients with Type 2 diabetes mellitus. Measurements: Adiponectin, leptin, high-sensitivity C-reactive protein (hs-CRP), fasting plasma insulin, glucose, glycated hemoglobin and full lipid profile. Patients were classified on the basis of the degree of adiposity, insulin resistance (IR) (homeostasis model assessment of insulin resistance (HOMA-IR)) and the number of the American Heart Association and the National Heart, Lung and Blood Institute criteria of the metabolic syndrome. Results: Adiponectin levels were inversely correlated with age, indices of obesity, IR and hs-CRP. Overweight/obese and nonobese insulin-sensitive patients had significantly higher (Po0.05) adiponectin levels than those with IR despite similar body mass index and waist circumference. Therefore, within each category of obesity stratification, lower adiponectin levels were associated with IR. Adiponectin showed stepwise decrease with increasing number of the criteria for diagnosis of the metabolic syndrome. Using multiple logistic regression, the odds ratio of the metabolic syndrome as predicted by adiponectin was 0.73 (95% confidence interval 0.53-0.96; P ¼ 0.04). At cutoff point of 18 ng/ml, the diagnostic sensitivity and specificity of adiponectin for the metabolic syndrome were 83 and 65%, respectively, in male patients and 92 and 41%, respectively, in female patients. Receiver operating characteristic analysis showed that adiponectin had significantly higher area under the curve compared with leptin, leptin:adiponectin ratio and triglycerides for the detection of the metabolic syndrome. Conclusions: In patients with Type 2 diabetes, adiponectin concentrations are closely related to IR and the components of the metabolic syndrome. Adiponectin concentration may be a useful addition to the criteria used for identifying obese subjects with the metabolic syndrome.

show abstract

Contribution of visceral fat accumulation to the development of coronary artery disease in non-obese men

Cited by 381 publications

References 31 publications

The role of fat topology in the risk of disease

The role of fat topology in the risk of disease

Potential impact of renin–angiotensin system inhibitors and calcium channel blockers on plasma high-molecular-weight adiponectin levels in hemodialysis patients

Adiponectin, insulin resistance and clinical expression of the metabolic syndrome in patients with Type 2 diabetes

Contact Info

Product

Resources

About