Usefulness of Hypertriglyceridemic Waist Phenotype in Type 2 Diabetes Mellitus to Predict the Presence of Coronary Artery Disease as Assessed by Computed Tomographic Coronary Angiography

被引：46

作者：

de Graaf, Fleur R. ^{[1
]}

Schuijf, Joanne D. ^{[1
]}

Scholte, Arthur J. ^{[1
]}

Djaberi, Roxana ^{[1
]}

van Velzen, Joella E. ^{[1
,3
]}

Roos, Cornelis J. ^{[1
,3
]}

Kroft, Lucia J. ^{[2
]}

de Roos, Albert ^{[2
]}

van der Wall, Ernst E. ^{[1
,3
]}

Jukema, J. Wouter ^{[1
,3
]}

Despres, Jean-Pierre ^{[4
]}

Bax, Jeroen J. ^{[1
]}

机构：

[1] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands

[2] Leiden Univ, Med Ctr, Dept Radiol, Leiden, Netherlands

[3] Interuniv Cardiol Inst Netherlands, Utrecht, Netherlands

[4] Univ Laval, Quebec Heart & Lung Inst, Quebec City, PQ, Canada

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2010年 / 106卷 / 12期

关键词：

ATHEROGENIC METABOLIC TRIAD; DENSE LDL; HYPERINSULINEMIA; ASSOCIATION;

D O I：

10.1016/j.amjcard.2010.08.015

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

The present study tested whether in patients with type 2 diabetes mellitus (DM) the combination of increased waist circumference and increased plasma triglyceride (TG) levels can predict the presence of coronary artery disease (CAD) as assessed by multidetector computed tomographic coronary angiography (CTA). In 202 patients with type 2 DM who were clinically referred for CTA, waist circumference and TG levels were measured. Patients were divided into 4 groups according to waist circumference measurements and TG levels. Increased waist circumference and TG levels (n = 61, 31%) indicated the presence of the hypertriglyceridemic waist phenotype. Patients with low waist circumference and TG (n = 49, 24%) were considered the reference group. Physical examination and blood measurements were performed. CTA was used to determine presence and severity of CAD. In addition, plaque type was evaluated. Plasma cholesterol levels were significantly increased in the group with increased TG levels and waist circumference, whereas high-density lipoprotein cholesterol was significantly lower than in the reference group. There was a significant increase in the presence of any CAD (odds ratio 3.3, confidence interval 1.31 to 8.13, p <0.05) and obstructive CAD (>= 50%, odds ratio 2.9, confidence interval 1.16 to 7.28, p <0.05) in the group with increased TG level and waist circumference. In addition, a significantly larger number of noncalcified and mixed plaques was observed. In conclusion, in patients with type 2 DM, presence of the hypertriglyceridemic waist phenotype translated into a deteriorated blood lipid profile and more extensive CAD on CTA. Accordingly, the hypertriglyceridemic waist phenotype may serve as a practical clinical biomarker to improve risk stratification in patients with type 2 DM. (C) 2010 Elsevier Inc. All rights reserved. (Am J Cardiol 2010;106:1747-1753)

引用

页码：1747 / 1753

页数：7

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