[Visceral obesity as a pathogenetic factor of ischemic heart disease]

Relationship between visceral obesity and development of ischemic heart disease (IHD) has been widely studied during last years. Fat tissue is considered to be endocrine and secretory organ liberating wide spectrum of protein and signal factors-adipokines. We studied 27 healthy subjects and 55 patients (including 39 patients with IHD) with visceral and gynoid obesity. Abdominal fat content was assessed quantitatively by computed tomography. It was proven that total volume of fat tissue in visceral obesity is substantially elevated especially in mesogastrium, omentum, and around portal vein, where increased amounts of very low density lipoproteins, free fatty acids, and low density lipoproteins are generated. Enhanced inflow of free fatty acids and glucose to liver constitutes pathophysiologic basis of visceral obesity. This very process creates elevation of optical density of tissue in visceral obesity. Elevation of low density lipoproteins, very low density lipoproteins, and cholesterol are important factors in pathogenesis of IHD.