kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2018-7-1-21-28kpccz-389Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESЭПИКАРДИАЛЬНОЕ ОЖИРЕНИЕ КАК ОДИН ИЗ ОСНОВНЫХ КРИТЕРИЕВ МЕТАБОЛИЧЕСКИ ТУЧНОГО ФЕНОТИПА ОЖИРЕНИЯ И ПРЕДИКТОРОВ СУБКЛИНИЧЕСКОГО АТЕРОСКЛЕРОЗАEPICARDIAL OBESITY AS ONE OF THE BASIC CRITERIA FOR METABOLICALLY UNHEALTHY OBESITY PHENOTYPE AND THE PREDICTOR OF SUBCLINICAL ATHEROSCLEROSISОттА. В.OttA. V.

Corresponding author: Ott Anna, address: Russian Federation, 656055, Barnaul, 46, Malakhova Street

ott-88@mail.ruЧумаковаГ. А.ChumakovaG. A.Федеральное государственное бюджетное образовательное учреждение высшего образования «Алтайский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияAltai State Medical UniversityRussian Federation201827032018712128Copyright © Отт А.В., Чумакова Г.А., 20182018Отт А.В., Чумакова Г.А.Ott A.V., Chumakova G.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/389Цель

Цель. Изучить влияние эпикардиального ожирения (ЭО) на развитие дислипидемии и мультифокального субклинического атеросклероза, а также оценить прогностическую значимость различных критериев ожирения в формировании сердечно-сосудистого риска (ССР).

Материалы и методы

Материалы и методы. В исследование вошли мужчины с артериальной гипертензией (АГ) и отсутствием клинических проявлений атеросклероза любых локализаций, сахарным диабетом 2 типа. Обследуемые были разделены на две группы в зависимости от метаболических фенотипов ожирения по показателям толщины эпикардиальной жировой ткани (ЭЖТ) и индекса массы тела (ИМТ). Обе группы были сопоставимы по величине окружности талии (ОТ) и имели абдоминальное ожирение (ОТ ≥94см). В группах проводилась сравнительная оценка показателей липидного обмена, Апо-белков, а также оценка атеросклероза коронарных артерий методом мультиспиральной компьютерной томографии и брахиоцефальных артерий при помощи дуплексного сканирования. Толщина ЭЖТ определялась методом эхокардиографии.

Результаты

Результаты. Выявлена значимая взаимосвязь ЭО с развитием дислипидемии и мультифокального субклинического атеросклероза. Установлена низкая прогностическая значимость ОТ и ИМТ в формировании ССР.

Заключение

Заключение. ЭО оказывает значимое влияние на формирование субклинического атеросклероза коронарных и брахиоцефальных артерий. При оценке ССР у пациентов с АГ без других установленных сердечнососудистых заболеваний наряду с традиционными факторами риска необходимо измерять толщину ЭЖТ как критерий висцерального ожирения, вносящий важный вклад в формирование кардиометаболических нарушений. 

Aim

Aim. To assess the effect of epicardial obesity on the development of dyslipidemia and polyvascular subclinical atherosclerosis, and to assess the prognostic significance of various obesity criteria in the development of cardiovascular risk.

Methods

Methods. Male patients with arterial hypertension and without clinical symptoms of atherosclerosis of any localization and type 2 diabetes were included in the study. All the patients were enrolled into two groups, depending on the metabolic phenotypes of obesity assessed by epicardial fat thickness and body mass index. Both groups were comparable in waist circumference. All patients in both groups had abdominal obesity (AO≥94 cm). The study groups underwent a comparative assessment of parameters of lipid metabolism and levels of Apo-proteins. Coronary atherosclerosis was measured with multispiral computed tomography. Atherosclerotic lesions of brachiocephalic arteries were assessed by duplex scanning was performed. Epicardial fat thickness was measured by echocardiography.

Results

Results. Significant relationships between epicardial obesity and the development of dyslipidemia and polyvascular subclinical atherosclerosis have been determined. Waist circumference and body mass index have low prognostic significance for developing cardiovascular risk.

 Conclusion

 Conclusion. Epicardial obesity significantly affects the development of subclinical atherosclerosis of the coronary and brachiocephalic arteries. The assessment of cardiovascular risk in patients with arterial hypertension and without other diagnosed cardiovascular diseases reported that it is necessary to measure epicardial fat thickness along with traditional risk factors. Epicardial fat thickness is considered to be a criterion for visceral obesity, contributing to the development of cardiometabolic disorders. 

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The authors declare that there are no conflicts of interest present.