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Korean J Obes 2012; 21(1): 57-64

Published online March 30, 2012

Copyright © Korean Society for the Study of Obesity.

The Effect of Visceral Fat Area and Adipocytokines on Acute Myocardial Infarction: A Case-Control Study in Adult Korean Population

Kang-Kon Lee, Young-Sung Suh(1), Keun-Sang Yum*

Department of Family Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Department of Family Medicine, Keimyung University Dongsan Medical Center(1)

Background: This study aimed to analyze visceral fat area (VFA) and the pattern of secretion of adiponectin, leptin, TNF-α, IL-6, and IL-10. It also studies the effect of VFA and adipocytokines on the risk of Acute myocardial infarction (AMI) in adult Korean population.
Methods: A patient group (PG) consisting of 121 patients, who were hospitalized for AMI from 2008 to 2009, and a control group (CG) consisting of 115 healthy adults, who visited the same hospital for health examination within the same period, were included in this study. Physical measurements were performed and VFA was measured using computed tomography. Lipid, metabolic index,
adipocytokine levels were also measured after 12 hours of fasting.
Results: BMI, waist circumference, levels of leptin, TNF-α, and IL-6 were significantly higher in the PG, while adiponectin level was significantly higher in the CG.
According to the comparison study analyzed by gender, VFA level was significantly higher in the PG, and IL-10 level was significantly higher in the CG. After adjusting for the conventional risk factors (CRF) of AMI, regression analysis showed that adiponectin and IL-10 levels reduced the risk of AMI; whereas VFA, TNF-α, leptin, and IL-6 increased the same risk.
Conclusion: It is postulated that adipocytokines and VFA will act as independent risk factors of AMI regardless of CRF of coronary artery disease.

Keywords: Myocardial infarction, Visceral fat, Adipocytokines


Clinical characteristics of study subjects



Distribution of fat measures and adipocytokines for women and men



Logistic regression analyses for baseline adipocytokines and risk of myocardial infraction



Independent predictors of MI; stepwise logistic regression analyses including traditional cardiovascular risk factors and VFA, adipocytokines


  1. Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol 2006;5:1.
    Pubmed KoreaMed CrossRef
  2. Fox CS, Massaro JM, Hoffmann U, Pou KM, Maurovich -Horvat P, Liu CY, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007;116:39-48.
    Pubmed CrossRef
  3. Steffes MW, Gross MD, Lee DH, Schreiner PJ, Jacobs DR Jr. Adiponectin, visceral fat, oxidative stress, early macrovascular disease: the Coronary Artery Risk Development in Young Adults Study. Obesity (Silver Spring) 2006;14:319-26.
    Pubmed CrossRef
  4. Kim DG, Lee KM, Jung SP. Clinical Significance of Abdominal Deep Subcutaneous Adipose Tissue in the Obese: Associations with Cardiovascular and Risk Factors. J Korean Acad Fam Med 2007;28:100-5.
  5. Kopff B, Jegier A. Adipokines: adiponectin, leptin, resistin and coronary heart disease risk. Przegl Lek 2005;62 Suppl 3:69-72.
    Pubmed
  6. Kim JY, Shin HW, Jeong IK, Cho SW, Min SJ, Lee SJ, et al. The relationship of adiponectin, leptin and ghrelin to insulin resistance and cardiovascular risk factors in human obesity. Korean J Med 2005;69:631-41.
  7. Hwang JS, Kim YP, Park HK, Hwang HS. The association of visceral fat area with anthropometric variables and its risk for metabolic syndrome. J Korean Acad Fam Med 2005;26:766-73.
  8. Lim S, Jang HC. Clinical implication of adiponectin. Korean Diabetes J 2008;32:85-97.
    CrossRef
  9. Jung CH, Rhee EJ, Kim SY, Shin HS, Kim BJ, Sung KC, et al. Association between two SNPs (+45T>G and +276G>T) of the adiponectin gene and coronary artery diseases. Korean J Med 2006;70:393-401.
  10. Shim WS, Kim HJ, Kang ES, Rhee YM, Ahn CW, Lim SK, et al. The Relationship between the Leptin Concentration and the Small Dense Low Density Lipoprotein Cholesterol Concentration in Korean Type 2 Diabetic Patients. J Korean Soc Endocrinol 2006;21:319-27.
    CrossRef
  11. Haffner SM, Mykk?nen L, Rainwater DL, Karhap?? P, Laakso M. Is leptin concentration associated with the insulin resistance syndrome in nondiabetic men? Obes Res1999;7:164-9.
    Pubmed CrossRef
  12. Soderberg S, Ahren B, Jansson JH, Johnson O, Hallmans G, Asplund K, et al. Leptin is associated with increased risk of myocardial infarction. J Intern Med 1999;246:409-18.
    Pubmed CrossRef
  13. Wallace AM, McMahon AD, Packard CJ, Kelly A, Shepherd J, Gaw A, et al. Plasma leptin and the risk of cardiovascular disease in the west of Scotland coronary prevention study (WOSCOPS). Circulation 2001;104:3052-6.
    Pubmed CrossRef
  14. Cha BS, Kim SK. Role of Interleukin-6 in Human Obesity and Insulin Resistance. J Korean Diabetes Assoc 2001;25:332-6.
  15. Mohamed-Ali V, Goodrick S, Rawesh A, Katz DR, Miles JM, Yudkin JS, et al. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab 1997;82:4196-200.
    Pubmed CrossRef
  16. Pickup JC, Mattock MB, Chusney GD, Burt D. NIDDM as a disease of the innate immune system:association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia 1997;40:1286-92.
    Pubmed CrossRef
  17. Ko GJ, Kim JY, Kim MK, Suh SY, Choi HM, Hyun YY, et al. Association of IL-10 genotypes with cardiovascular risk factors in patients with hemodialysis. Korean J Med 2005;68:528-36.
  18. Moore KW, O'Garra A, de Waal Malefyt R, Vieira P, Mosmann TR. Interleukin-10. Annu Rev Immunol 1993;11:165-90.
    Pubmed CrossRef
  19. Smith DA, Irving SD, Sheldon J, Cole D, Kaski JC. Serum levels of the anti-inflammatory cytokine interleukin-10 are decreased in patients with unstable angina. Circulation 2001;104:746-9.
    Pubmed CrossRef
  20. Fasshauer M, Paschke R. Regulation of adipokines and insulin resistance. Diabetologia 2003;46:1594-603.
    Pubmed CrossRef
  21. Kappes A, Loffler G. Influences of ionomycin, dibutyrylcyclo-AMP and tumor necrosis factor-alpha on intracellular amount and secretion of apM1 in differentiating primary human preadipocytes. HormMetab Res 2000;32:548-54.
    Pubmed CrossRef
  22. Diez JJ, Iglesias P. The role of the novel adipocyte derived hormone adiponectin in human disease. Eur J Endocrinol 2003;148:293-300.
    CrossRef
  23. Diamond FB Jr, Cuthbertson D, Hanna S, Eichler D. Correlates of adiponectin and the leptin/adiponectin ratio in obese and non-obese children. J Pediatr Endocrinol Metab 2004;17:1069-75.
    Pubmed CrossRef
  24. Satoh N, Naruse M, Usui T, Tagami T, Suganami T, Yamada K, et al. Leptin-to-adiponectin ratio as a potential atherogenic index in obese type 2 diabetic patients. Diabetes Care 2004;27:2488-90.
    Pubmed CrossRef