russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2013-6-28-32russjcardiol-433Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESНЕИНВАЗИВНЫЙ МАРКЁР ИНСУЛИНОРЕЗИСТЕНТНОСТИ У ПАЦИЕНТОВ С ОЖИРЕНИЕМA NON-INVASIVE MARKER OF INSULIN RESISTANCE IN PATIENTS WITH OBESITYВеселовскаяН. Г.VeselovskayaN. G.

к. м.н., старший научный сотрудник отдела мультифокального атеросклероза, врач Алтайского краевого кардиологического диспансера

ЧумаковаГ. А.ChumakovaG. A.

д. м.н., профессор кафедры госпитальной и поликлинической терапии, ведущий научный сотрудник отдела мультифокальногоатеросклероза

g.a.chumakova@mail.ruОттА. В.OttA. V.ГриценкоО. В.GritsenkoO. V.

аспирант, сотрудник отдела мультифокального атеросклероза

ФГБУ — НИИ комплексных проблем сердечно-сосудистых заболеваний СО РАМН, Кемерово; КГБУЗ — Алтайский краевой кардиологический диспансер, Барнаул, Россия.РоссияResearch Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; Altay Region Cardiology Dispanser, Barnaul, RussiaRussian FederationФГБУ — НИИ комплексных проблем сердечно-сосудистых заболеваний СО РАМН, Кемерово; ГБОУ ВПО- Алтайский государственный медицинский университет МЗ РФ, БарнаулРоссияResearch Institute for Complex Cardiovascular Disease Issues, Siberian Branch, Russian Academy of Medical Sciences, Kemerovo; Altay State Medical University, BarnaulRussian FederationКГБУЗ — Алтайский краевой кардиологический диспансер, Барнаул, Россия.РоссияAltay Region Cardiology Dispanser, Barnaul, RussiaRussian Federation201328122013062832Copyright © Веселовская Н.Г., Чумакова Г.А., Отт А.В., Гриценко О.В., 20132013Веселовская Н.Г., Чумакова Г.А., Отт А.В., Гриценко О.В.Veselovskaya N.G., Chumakova G.A., Ott A.V., Gritsenko O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/433

Инсулинорезистентность (ИР) и гормональная активность висцерального жира являются основными патогенетическими механизмами, связывающими ожирение и сердечно-сосудистые осложнения. До настоящего времени взаимосвязь эпикардиального ожирения с ИР изучена недостаточно. 

Цель

Цель. Изучить взаимосвязь толщины эпикардиальной жировой ткани (тЭЖТ) и определить прогностическую ценность и пороговое значение тЭЖТ для диагностики ИР. 

Материал и методы

Материал и методы. В исследование было включено 186 мужчин (54,4±9,1 лет), средний индекс массы тела (ИМТ) — 34,23±3,97 кг/м². С целью оценки ИР проводилось определение инсулина и индекса HOMA-IR; тЭЖТ измерялась с помощью ЭхоКГ в миллиметрах за свободной стенкой правого желудочка в систолу в парастернальной позиции по длинной и короткой оси левого желудочка. 

Результаты

Результаты. Средние показатели тЭЖТ в группе (ИР+) были выше — 7 (7,0;9,0), чем в группе (ИР-) — 5 (4,0;6,0) (р<0,001). Получено уравнение логистической регрессии с процентом верного предсказания 91%, коэффициент связи Д-Зомера 0,837. Оптимальный порог отсечения для тЭЖТ, как неинвазивного предиктора ИР составил

Insulin resistance (IR) and hormone activity of visceral fat are the main pathogenetic mechanisms which link obesity and cardiovascular complications. Until recently, the association between epicardial adiposity and IR has been understudied. 

Aim

Aim. To investigate the association between the thickness of epicardial fat tissue (tEFT) and IR and to determine the predictive value and threshold levels of tEFT for the diagnostics of IR. 

Material and methods

Material and methods. The study included 186 men (mean age 54,4±9,1 years) with the mean body mass index of 34,23±3,97 kg/m². IR was assessed by the levels of insulin and HOMA-IR index. The echocardiography measurement of tEFT (mm behind the free right ventricular wall) was performed in a systole, in a parasternal position on the long and short left ventricular axis. 

Results

Results. Mean tEFT levels in the IR-positive group were significantly higher (7,0 (7,0;9,0)) than in the IR-negative group (5 (4,0;6,0); p<0,001). In the logistic regression analyses, the proportion of accurate predictions was 91%, and the Somers’ D-value was 0,837. The optimal cut-off for tEFT, as a non-invasive IR marker, was

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The authors declare that there are no conflicts of interest present.