Coexistence of Visceral Fat Accumulation and Sleep-Disordered Breathing Correlates with Coronary Artery Disease

  • Nakagawa Yasuhiko
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.
  • Kishida Ken
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University. Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University.
  • Funahashi Tohru
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University. Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University.
  • Yanagi Koji
    Department of Cardiology, Kenporen Osaka Central Hospital.
  • Shimomura Iichiro
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University.

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Abstract

Aim: Visceral adiposity is linked with sleep-disordered breathing (SDB) (called Syndrome Z), and both correlate with coronary artery disease (CAD). The aim of the present study was to determine the significance of excess visceral fat, SDB and circulating levels of biomarkers in CAD in Japanese men.<BR>Methods: SDB, visceral fat area (VFA), and circulating levels of biomarkers were assessed in 60 Japanese male patients who underwent coronary angiography and overnight cardiorespiratory monitoring.<BR>Results: Age-adjusted logistic analysis showed a significant relationship between CAD and diabetes, hypertension, dyslipidemia, SDB (AHI ≥5 events/hour), visceral fat accumulation (VFA ≥100 cm2), the combination of visceral fat accumulation and hypertension or dyslipidemia, as well as the combination of visceral fat accumulation and SDB. Patients with VFA ≥100 cm2 and SDB had significantly lower serum adiponectin levels and higher serum soluble CD40 ligand levels than those with VFA<100 cm2 and SDB. The prevalence of CAD was significantly higher in patients with VFA ≥100 cm2 and SDB than in patients with VFA <100 cm2 and AHI <5 events/hour, patients with VFA<100 cm2 and AHI ≥5 events/hour or patients with VFA ≥100 cm2 and AHI <5 events/hour (93% versus 14%, p <0.001, 53%, p <0.01 or 63%, p <0.01, respectively).<BR>Conclusions: The present study indicates that patients with both visceral fat accumulation and SDB develop CAD in association with hypoadiponectinemia and inflammatory activity.

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