Visceral fat and coronary pathology in male adolescents

Abstract

OBJECTIVE: To ®nd out whether coronary atherosclerotic lesions and their precursors in male adolescents are associated with the amount of mesenteric and omental fat. SUBJECTS: A series of 40 forensic autopsy cases of ante-mortem healthy boys of 13 ± 19 y of age were investigated. METHODS: Body height and weight, waist and hip circumferences and the thickness of the abdominal subcutaneous fat were measured, the body mass index (BMI) and waist-to-hip ratio (WHR) were calculated, and omental and mesenteric fat deposits were weighed. The intimal surface of the coronary arteries covered by lesions was measured by planimetry, and the thickness of the intima was measured by computerized image analysis. Intimal macrophage foam cells and smooth muscle cells were detected by immunohistochemisty, and macrophages were quanti®ed. RESULTS: The intima thickness of the left anterior descending artery (LAD) and in the thickest lesion varied signi®cantly across the tertiles of visceral fat when adjusted for age, being highest when the sum weight of omental and mesenteric fat exceeded 358 g. The intima thickness of the circum¯ex artery (CX) varied signi®cantly across the tertiles of waist circumference when adjusted for age. No statistically signi®cant associations with other indicators of obesity were found. Macrophage foam cells were present in the lesions and their maximal densityamm 2 correlated signi®cantly with intima thickness in the LAD and CX. The maximal density of macrophages in CX and the right coronary artery (RCA) and in the thickest lesion varied signi®cantly across the tertiles of visceral fat when adjusted for age, being highest when the amount of fat exceeded 358 g. The macrophage density also varied signi®cantly across the tertiles of waist circumference in all vessels. CONCLUSIONS:The results indicate that early macrophage-rich coronary lesions are associated with increased amounts of visceral fat in adolescent male individuals. This emphasizes the importance of effective prevention of weight gain in individuals with a tendency to accumulate visceral fat at an early age.

Targeting abdominal obesity in cardiology: Can we be effective?

“…From a clinical point of view, it is important to note that maximal density of macrophages/mm 2 in atherosclerotic lesions is associated with visceral obesity (30), reduced coronary flow reserve related to body fat distribution and insulin resistance (31), and the MetS associated with lipid-rich plaque (32). In a systematic review and meta-analysis of longitudinal studies (33), it has been reported that individuals with the MetS are at increased risk of a cardiovascular events and death (relative risk 1.78).…”

Peroxisome proliferator activated receptor gamma activity is low in mature primary human visceral adipocytes

“…components of the metabolic syndrome [2]. It is generally considered that the unfavourable prognosis in subjects with abdominal obesity is due to large amounts of intra-abdominal fat [3][4][5][6]. Human omental fat cells display a high number of beta-adrenergic receptors and reduced antilipolytic effect of insulin, compared with subcutaneous fat cells, resulting in a high release of fatty acids from this fat cell depot [7,8].…”

Expression of estrogen receptors in the coronary arteries of young and premenopausal women in relation to central obesity

“…In all, 52 female cadavers aged between 18 and 49 y were examined and data were obtained from police records and medical records, as described previously. 10,16 The cases consisted of 11 sudden deaths from unexpected natural causes (four cases of subarachnoid hemorrhage, two cases of pulmonary embolism, three cases of epilepsy and two cases of coronary artery disease with acute myocardial infarction), 19 accidental deaths, 20 suicides and two homicides. None of the subjects were reported to have had any hormone replacement therapy and none of them were pregnant.…”

“…16 Body mass index (BMI; kg/m 2 ) and waist-to-hip ratio (WHR) were calculated from these measurements.…”