medigraphic.com

2009, Número 2

<< Anterior Siguiente >>

Rev Med Inst Mex Seguro Soc 2009; 47 (2)


Grasa visceral y alteraciones metabólicas en hombres hipertensos

Brito-Zurita OR, Verdín-García P, Domínguez-Banda A, Cortez-Valenzuela AE, Villanueva-Pérez RM, Torres-Tamayo M

Idioma: Español
Referencias bibliográficas: 36
Paginas: 135-140
Archivo PDF: 189.36 Kb.


RESUMEN

Objetivo: determinar patrón metabólico y de grasa visceral en hombres hipertensos con y sin obesidad.
Métodos: estudio transversal analítico de 60 hombres hipertensos con y sin obesidad. Se obtuvo antropometría y muestras sanguíneas en ayuno y dos horas poscarga oral de glucosa (PCOG) para determinar glucosa, fibrinógeno y perfil de lípidos. La grasa visceral y la subcutánea fueron calculadas con tomografía axial computarizada.
Resultados: los hipertensos obesos eran más jóvenes (48 ± 7 versus. 57 ± 6 años), tuvieron valores mayores de presión arterial, perfil de lípidos, circunferencia de cintura, grasa abdominal total y grasa subcutánea (420 versus 321 cm2, p ‹ 0.001 y 257 versus 159 cm2, p = 0.03, respectivamente). La grasa visceral fue similar en ambos grupos (163 versus 162 cm2). Los hipertensos no obesos tuvieron niveles más altos de glucosa en PCOG. Ambos grupos tuvieron niveles aumentados de fibrinógeno y triglicéridos con niveles bajos de c-HDL.
Conclusiones: los hipertensos tuvieron aumento de grasa visceral independientemente del IMC. Los obesos mostraron un perfil metabólico más deletéreo. La elevación de glucosa poscarga y la intolerancia a la glucosa pudieron estar relacionadas con mayor edad del grupo de no obesos.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Stamler J. Epidemic obesity in the United States. Arch Med Intern Med 1993;153(9):1040-1044.

  2. Seidell JC. Obesity in Europe: scaling an epidemic. Int J Obes Relat Metab Disord 1995;19(Suppl 3):S1-S4.

  3. Yamashita S, Nakamura T, Shimomura I, Nishida M, Yoshida S, Kotani K. Insulin resistance and body fat distribution. Diabetes Care 1996;19(3):287-291.

  4. Rao SV, Donahuev M, Pi-Sunyker X, Fuster V. Obesity as a risk factor in coronary artery disease. American Heart J 2001;142(6):1102-1107.

  5. Klein S, Burke LE, Bray GA, Blair S, Allison DB, Pi-Sunyer X, et al. Clinical implications of obesity with specific focus on cardiovascular disease: a statement for professionals from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: endorsed by the American Collage of Cardiology Foundation. Circulation 2004;110(18):2952-2957.

  6. Sánchez-Castillo CP, Velásquez-Monroy O, Lara- Esqueda A, Berber A, Sepúlveda J, Tapia-Conyer R, et al. Diabetes and hypertension increases in a society with abdominal obesity: results of the Mexican National Health Survey 2000. Public Health Nutr 2005;8(1):53-60.

  7. Bellanger TM, Bray GA. Obesity related morbidity and mortality. J LA State Med Soc 2005;157(Spec 1):S42-S49.

  8. Donahue RP, Abbott RD, Bloom El, Reed DM, Yano K. Central obesity and coronary heart disease in men. Lancet 1987;1(8537):821-824.

  9. Ritchie SA, Connell JM. The link between abdominal obesity, metabolic syndrome and cardiovascular disease. Nutr Metab Cardiovasc Dis 2007;17(4):319-326.

  10. Yamamoto M, Egusa G, Hara H, Yamakido M. Association of intraabdominal fat and carotid atherosclerosis in non obese middle-aged men with normal glucose tolerance. Int J Obes Relat Metab Disord 1997;21(10):948-951.

  11. Jonson D, Prud´homme D, Despres JP, Nadeau A, Tremblay A, Bouchard C. Relation of abdominal obesity to hyperinsulinemia and high blood pressure in men. Int J Obes Relat Metab Disord 1992;16(11):881-890.

  12. Abate N, Garg A, Peshock RM, Stray-Gundersen J, Grundy SM. Relationship of generalized and regional adiposity to insulin sensitivity in men. J Clin Invest 1995;96(1):88-98.

  13. Despres JP. Couillard C, Gagnon J, Bergeron J, Leon AS, Rao DC, et al. Race, visceral adipose tissue, plasma lipids, and lipoprotein lipase activity in men and women: the Health, Risk Factors, Exercise Training, and Genetics (HERETIGE) Family Study. Ateroscler Thromb Vasc Biol 2000; 20(8):1932-1938.

  14. Moreno LA, Quintela I, Fleta J, Sarria A, Roda L, Giner A, et al. Postprandial triglyceridemia in obese and non-obese adolescents. Importance of body composition and fat distribution. J Pediatr Endocrinol Metab 2001;14(2):193-202.

  15. Couillard C, Bergeron N, Pascot A, Almeras N, Bergeron J, Tremblay A, et al. Evidence for impaired lipolysis in abdominally obese men: postprandial study of apolipoprotein B-48- and B-100-containing lipoproteins. Am J Clin Nutr 2002;76(2):311-318.

  16. Secretaría de Salud. Norma Oficial Mexicana NOM 174-SSA1-1998, para el manejo integral de la obesidad. Rev Med Inst Mex Seguro Soc 2000;38(5):397-403.

  17. De Long DA, De Long AR, Weed PD, Lippel K, Rifkind BM. A comparison of methods for estimation of plasma low and very low density lipoprotein cholesterol. The Lipid Research Clinics Prevalence Study. JAMA 1986;256(17):2372-2374.

  18. Chowdhury B, Sjöström L, Alpsten M, Kostanty J, Kvist H, Löfgren R. A multicompartement body composition technique based on computerized tomography. Int J Obes Relat Metab Disord 1994; 18(4):219-234.

  19. Lai SW, Ng KC Overall obesity and abdominal obesity and the risk of metabolic abnormalities. Ir J Med Sci 2004;173(4):193-196.

  20. Lovejoy JC, de la Bretonne JA, Klemperer M, Tulley R. Abdominal at distribution and metabolic risk factors effects of race. Metabolism 1996;45(9):1119-1124.

  21. Goospaster BH, Thaete FL, Simoneau JA, Kelley DE. Subcutaneous and thigh muscle competition predict insulin sensitivity independently of visceral fat. Diabetes 1997;46(10):1579-1585.

  22. Björntorp P. Portal adipose tissue as a generator of risk factors for cardiovascular disease and diabetes. Arteriosclerosis 1990;10(4):493-496.

  23. Wajchenberg BL, Giannella-Netto D, da Silva ME, Santos RF. Depot-specific hormonal characteristics of subcutaneous and visceral adipose tissue and their relation to the metabolic syndrome. Horm Metab Res 2002;34(11-12):616-621.

  24. Jensen MD. Adipose tissue and fatty acid metabolism in humans. J R Soc Med 2002;95(Suppl 42):3-7.

  25. Tulloch-Reid MK, Hanson RL, Sebring NG, Reynolds JC, Premkumar A, Genovese AJ, et al. Both subcutaneous and visceral adipose tissue correlate highly with insulin resistance in African Americans. Obes Res 2004;12(8):1352-1359.

  26. Wagenknecht LE, Langefeld CD, Scherzinger AL, Norris JM, Haffner SM, Saad MF, et al. Insulin sensitivity, insulin secretion, and abdominal fat: the Insulin Resistance Atherosclerosis Study (IRAS) Family Study. Diabetes 2003;52(10):2490-2496.

  27. Cnop M, Landchild MJ, Vidal J, Havel PJ, Knowles NG, Carr DR, et al. The concurrent accumulation of intra-abdominal and subcutaneous fat explains the association between insulin resistance and plasma leptin concentrations: distinct metabolic effects of two fat compartments. Diabetes 2002; 51(4):1005-1015.

  28. Goodpaster BH, Kelley DE, Wing RR, Meier A, Thaete FL. Effects of weight loss on regional fat distribution and insulin sensitivity in obesity. Diabetes 1999;48(4):839-847.

  29. Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, et al. Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the metabolic syndrome. Diabetes 2004;3(8):2087-2094.

  30. Hernández-Ono A, Monter-Carreola G, Zamora-González J, Cardoso-Saldana G, Posadas-Sánchez R, Torres-Tamayo M, et al. Association of visceral fat with coronary risk factors in a population-based sample of postmenopausal women. Int J Obes Relat Metab Disord 2002;26(1):33-39.

  31. Hayashi T, Boyko EJ, Leonetti DL, McNeely MJ, Newell-Morris L, Kahn SE, et al. Visceral adiposity and the risk of impaired glucose tolerance: a prospective study among Japanese Americans. Diabetes Care 2003;26(3):650-655.

  32. Stern MP, Williams K, Haffner SM. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann Intern Med 2002;136(8):575-581.

  33. Terry RB, Wood PD, Haskell WL, Stefanick ML, Kraus RM. Regional adiposity patterns in relation to lipids, lipoprotein cholesterol, and lipoprotein subfraction mass in men. J Clin Endocrinol Metab 1989;68(1):191-199.

  34. Després JP. Health consequences of visceral obesity. Ann Med 2001;33(8):534-541.

  35. Lemieux I, Pascot A, Couillard C, Lamarche B, Tchernof A, Almeras N, Bergeron J, Gaudet D, Tremblay G, Prud’Homme D, Nadeau A, Després, JP. Hypertriglyceridemic waist: a marker of the atherogenic metabolic triad (hyperinsulinemia, hyperapolipoprotein B; small, dense LDL) in men? Circulation 2000;102(2):179-184.

  36. Tchernof A, Lamarche B, Prud’Homme D, Nadeau A, Moorjani S, Labrie F, Lupien PJ, Després JP. The dense LDL phenotype. Association with plasma lipoprotein levels, visceral obesity, and hyperinsulinemia in men. Diabetes Care 1996;19(6):629-637.




2020     |     www.medigraphic.com