Subcutaneous and visceral obesity in obese and underweight thin patients with cardiological profile

Abstract

Goal. To study thefeatures of subcutaneous and visceral obesity (VO) in relation to the body mass index (BMI) and to determine associative relationships between cardiometabolic riskfactors (CFR) in men sufferingfrom coronary artery disease (CAD) in combination with arterial hypertension (HA). Materials and methods. We examined 90 male patients of metabolic unhealthy phenotype (MUP) diagnosed with cardiac ischemia and HA of 1-3 degrees, of median age 61.2 ± 1.7years. Group I included 29 patients with IMB up to 25 kg/m², group 11-31 overweight patients with BMI > 25 kg/m², and ingroup III we had 30 obese patients with a BMI > 30 kg/m², while the control group consisted of 30 patients with healthy metabolic phenotype (МНР). Anthropometric and ultrasound indices of subcutaneous and visceral fat were studied, the thickness of intra-abdominal and epicardialfat(TIA/TEF) were assessed, indices of abdominal wallfat(AWF) and visceral obesity (VAI) were calculated and metabolic parameters (lipid profile and insulin resistance (HOMA-IR)) were determined. The magnitude of the intima - media complex (CIM) and endothelium dependent vasodilation (EDV) were assessed via the ultrasound. Results. In all groups of patients with MUP, the thickness of subcutaneous fat did not differ significantly. Dyslipidemia, remodeling of the vascular wall, constriction of the brachial artery was observed in patients with a BMI <25 kg/m², regardless of the thickness of subcutaneousfat. All indicators reflecting the metabolic «unhealth» increased with increasing weight. In obese patients, higher figures of TIA/TEF and AWF (higher in group III, respectively, were 103.1 ± 5.2 / 10.4 ± 0.5 mm and 1.17 ± 0.1). BMI was associated with TIA and AWF only in obese patients (p <0.01). With increasing weight, the parameters of vascular remodeling changed: the magnitude of CIM in groups II and III was 1.12 ± 0.08 and 1.17 ± 0.04 mm, vasoconstriction was recorded in 78.7% of obese patients. In obese patients, associative relationship between BMI and the magnitude of CIM, the indicators of EDV was revealed. Conclusion. Visceral fat deposition in patients with cardiac pathology contributes to a significant increase of CRF, associated with each other and aggravating vascular remodeling. Diagnosis of VO using ultrasound, an alternative anthropometric technique, allows us to talk about TIA as one of the leadingfactors of metabolic risk. The BMI continues to serve as one of the criteriafora high CRF in the MUP.