Abdominal obesity is a part of insulin resistance syndrome that is closely
linked to increased risk of coronary artery disease (CAD). Because fat tissue acts as
an endocrine target and source of hormone production, increased metabolism or
production of chemical messengers in fat tissue may result in metabolic perturbations
that contribute to occurrence and recurrence of coronary events. This dissertation
research entails two separate approaches. The first study, a cross-sectional analysis,
sought to determine whether serum cortisol responses to oral glucose loading are
associated with abdominal obesity, non-esterified fatty acid (NEFA) suppression, and
self-reported symptoms of depression in 26 non-diabetic coronary patients. We
conclude that lower cortisol responses to oral glucose loading are associated with
abdominal obesity, reduced NEFA suppression, and fewer symptoms of depression
(P���0.028). Future prospective studies should determine whether psychosocial risk
factors, such as depression and anxiety, increase cortisol production, whether increases
in cortisol production act synergistically with a positive energy balance in the
development of abdominal obesity, and whether increases in abdominal obesity lead to
increases in cortisol metabolism and insulin resistance.
C-reactive protein (CRP) is a marker of low-grade inflammation that is
associated with increased risk for recurrent events in coronary patients. Fat tissue also
secretes proinflammatory cytokines that stimulate hepatic production of CRP. Thus,
the second study, an intervention study, sought to determine whether the first three
months of cardiac rehabilitation could reduce serum concentrations of CRP and the
proinflammatory cytokine, tumor necrosis factor-�� (TNF-��), in our non-diabetic
coronary patients (N=26). Results from the intervention study showed significant
reductions in serum CRP levels (P=0.012) that were associated with reductions in
waist circumferences after cardiac rehabilitation (r=0.39, P=0.049). However,
changes in serum TNF-�� levels after cardiac rehabilitation were nonsignificant
(P=0.869). Thus, we conclude that cardiac rehabilitation may reduce the severity of
low-grade inflammatory conditions, in part, through reductions in waist circumference
in non-diabetic coronary patients. / Graduation date: 2001
| Identifer | oai:union.ndltd.org:ORGSU/oai:ir.library.oregonstate.edu:1957/32661 |
| Date | 27 September 2000 |
| Creators | Ogimoto, Kayoko |
| Contributors | Williams, Daniel P. |
| Source Sets | Oregon State University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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