Fat, Lipid Metabolism and Insulin in Coronary Artery Disease

To investigate the metabolic and atherogenic effect of intra-abdominal fat accumulation, we examined correlation between variables of lipid and glucose and the fat distribution of abdominen by using computed tomography. Subjects were 292 of male and 161 of female who underwent coronary angiography. Intra-abdominal fat area was correlated with insulin concentration at 120 min in oral glucose tolerance tests and triglyceride level in male, on the other hand, in female were HDL-cholesterol level, apolipoprotein B, glucose area under curve and insulin concentration at 60 and 120 min. In an aspect of atherogenic effect of Intra-abdominal fat, it was not atherogenic in isolated state in male, but atherogenic in diabetic female. Intra-abdominal fat was accompanied with hypertension and mid-band, which appeared between alpha and beta band in polyacrylamide diskgel electrophoresis. Cluster of Intra-abdominal fat accumulation, hypertension and mid-band was atherogenic in male, in which insulin resistance play an important role in the coronary artery disease. On the contrary, Intra-abdominal fat accumulation accompanied with exacerbation of glucose tolerance, hypertensive and high level of apolipoprotein B in female. We concluded that visceral fat accumulation was a generator of metabolic syndrome X in male and was a progression factor for diabetes, hypertensive and high apolipoprotein B level in female. (Hypertens Res 1996; 19 Suppl. I: S69-S74)