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Kokyu to Junkan Volume 43, Issue 9 （September 1995）

呼吸と循環 43巻9号（1995年9月発行）

Japanese English

研究

冠動脈危険因子に及ぼす脂肪肝の影響—内臓脂肪型肥満との関係 The Influence of Fatty Liver on Coronary Risk Factors:A relationship between fatty liver and visceral fat obesity 河合直樹 ¹ , 河合達雄 ¹ , 河合潔 ² Naoki Kawai ¹ , Tatsuo Kawai ¹ , Kiyoshi Kawai ² ¹河合内科医院 ²河合内科クリニック ²Kawai Medical Clinic キーワード：脂肪肝 , 内臓脂肪型肥満 , 冠動脈危険因子 , fatty liver , obesity , coronary risk factors Keyword: 脂肪肝 , 内臓脂肪型肥満 , 冠動脈危険因子 , fatty liver , obesity , coronary risk factors pp.915-921

発行日 1995年9月15日 Published Date 1995/9/15

DOI https://doi.org/10.11477/mf.1404901120

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Abstract 文献概要
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　近年増加している脂肪肝の冠危険因子に及ぼす影響と内臓型肥満との関係を検討した．35歳以上の対象男性735名のうち脂肪肝（＋）138例では同（−）よりBMIが有意に大で（25.7±2.6vs22.3±2.6），著しい肥満を認めた．対象中BMIマッチした393名を体型（正常型と肥満型）と脂肪肝の有無で4つの群（1群：正常型，2群：正常型＋脂肪肝，3群：肥満型，4群：肥満型＋脂肪肝）に分類し検討した．中性脂肪の平均値，異常者率は正常型，肥満型とも脂肪肝（＋）で（−）より有意に高く，各脂質項目の平均値は1→3→2→4群の順に増加（HDL-Cでは低下）し，Hb_A1cと眼底異常は2群で多かった．4群では他群より尿酸と心拍数が有意に多く（後者は内臓脂肪蓄積による交感神経活性の亢進を示唆），中等症以上・治療中の高血圧者も高率の傾向にあった．脂質，糖代謝などの冠危険因子に及ぼす影響は肥満より脂肪肝のほうが強い傾向にあり，肥満による脂肪肝（4群）では内臓（腹腔内）脂肪蓄積との関連が示唆された．

Risk factors for coronary atherosclerosis were studied in cases of fatty liver, and a relationship between fatty liver and visceral fat obesity was estimated. Body mass index (BMI) was larger in 138 males with fatty liver than in 597 males without (25.7±2.6 vs 22.3±2.6) . Subjects were divided into 4 subgroups : group 1=obe-sity (-) and fatty liver (-). group 2=obesity (-) and fatty liver (+), group 3=obesity (+) and fatty liver (-), group 4=obesity (+) and fatty liver (+). In BMI, group 1 was matched with group 2, and group 3 with group 4, respectively. Serum levels of triglyceride and the preva-lence of hypertriglyceridemia were higher in groups with fatty liver (groups 2 and 4) than in groups without (groups 1 and 3). Serum levels of lipid (triglyceride, total cholesterol, HDL-C, LDL-C and atherogenicindex) in each groups (group 1 ＜group 3＜group 2 ＜ group 4) showed the close relationship to fatty liver compared with obesity. Serum levels of HbA1c and the prevalence of abnoral findings in fumduscopy were high-est in group 2. Mean values of uric acid and heart rates, and the prevalence of moderate or severe hypertension were highest in group 4, and these results suggested the close relationship between fatty liver induced by obesityand viceral fat accumulation.

In conclusion, coronary risk factors increased in males with fatty liver than in males without irrespective of obesity, and fatty liver induced by obesity was consid-ered to be related to visceral fat accumulation.