抄録
The relationship between risk factors such as hyperlipoproteinemia, diabetes mellitus (DM) or hypertension and the severity of atherosclerosis in coronary artery and abdominal aorta was investigated in 65 patients of coronary heart disease (CHD). The coronary stenosis index (CSI) was significantly correlated with the number of affected major coronary arteries (75% or more stenosis) and also with the wall thickening and stenosis index of the lower abdominal aorta assessed by the enhanced computed tomography (SI). All of 13 CHD patients with familial hypercholesterolemia (FH) were under 60 years of age, and SIs of them were not so high as CSIs. Hyperremnantemia defined as 200mg/dl or more of mid-band lipoprotein concentration became a risk factor of CHD such as single or double vessel disease occured in middle ages. Eleven of 19 patients of DM with low or intermediate insulin response on 75g oral glucose tolerance test reached CHD at 60 years or later, of whom 10 were suffered from double or triple vessel diseases with high score of SI. No correlation was seen between CSI and age in CHD group, but SI was significantly correlated with age (p<0.05).
In conclusion, hyperlipoproteinemia appeared from childhood was considered to make the progression of coronary atherosclerosis selectively, resulting in the occurence of CHD in comparative younger age, while DM, manifested mostly after 40 years of age, frequently got triple vessel disease as a result of general atherosclerosis with severe atherosclerotic change of abdominal aorta in 60 years or older.
