Coexistence of visceral fat and multiple risk factor accumulations is strongly associated with coronary artery disease in Japanese (The VACATION-J study)

Abstract

Aim: Multiple risk factor syndrome is a target for the prevention of coronary artery disease (CAD). A cluster of multiple risk factors, such as hypertension, glucose intolerance, and/or dyslipidemia, is encountered in Japanese without and with excess visceral fat. The present study investigated the relationship between multiple risk factor accumulation and CAD in Japanese without and with visceral fat accumulation. Methods: The study subjects comprised 257 Japanese with suspected CAD (males/females=153/ 104), who underwent 64-row multislice computed tomography (CT) coronary angiography and visceral fat area (VFA) measurement by CT. Based on the Japanese criteria for visceral fat accumulation, they were divided into those with VFA < 100 and ≥100 cm2. Results: In subjects with VFA < 100 cm2, the age- and sex-adjusted odds ratios (ORs) for 2 and 3 risk factors were 5.33 (95% confidence intervals; 1.04-27.38, p=0.0449) and 4.07 (0.72-23.15, p=0.1138), respectively, compared with VFA < 100 cm2 and 0 risk factor set at 1.0 (p=0.0569 for trend). In contrast, the respective ORs for subjects with VFA ≥100 cm2 were much higher [6.46 (1.25-33.44, p=0.0261) and 20.42 (3.60-115.73, p=0.0007)] (p<0.0001 for trend). The multivariate adjusted model demonstrated a significant relative excess CAD risk of 1.08 (p=0.0484) and 5.01 (p < 0.0001) for the interactions of 2 risk factors and VFA ≥100 cm2, and 3 risk factors and VFA ≥100 cm2, whereas multiple risk factor accumulation was not related with the increase of CAD risk in subjects with VFA < 100 cm2. Conclusions: Coexistence of visceral fat and risk factor accumulations is strongly associated with CAD in Japanese.