Manifold implications of obesity in ischemic heart disease among Japanese patients according to covariance structure analysis: Low reactivity of B-type natriuretic peptide as an intervening risk factor

• Published in: PloS one Vol. 12; no. 5; p. e0177327
• Main Authors: Tsutsumi, Joshi, Minai, Kosuke, Kawai, Makoto, Ogawa, Kazuo, Inoue, Yasunori, Morimoto, Satoshi, Tanaka, Toshikazu, Nagoshi, Tomohisa, Ogawa, Takayuki, Yoshimura, Michihiro
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 08.05.2017; Public Library of Science (PLoS)
• Subjects: Acute coronary syndromes; Adipose tissue; Aged; Analysis; Biology and Life Sciences; Body mass; Body mass index; Brain natriuretic peptide; Cardiology; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Coronary artery disease; Covariance; Diabetes; Diabetes mellitus; Dyslipidemia; Factor analysis; Female; Health aspects; Health risk assessment; Health risks; Heart; Heart diseases; Heart failure; Humans; Hypertension; Hypoxia; Insulin resistance; Internal medicine; Ischemia; Japan; Male; Medicine; Medicine and Health Sciences; Metabolic disorders; Metabolic syndrome; Middle Aged; Mortality; Myocardial ischemia; Myocardial Ischemia - complications; Natriuretic Peptide, Brain; Obesity; Obesity - complications; Patients; Peptides; Physical Sciences; Promotion; Reactivity; Regression analysis; Research and Analysis Methods; Risk analysis; Risk Factors; Rodents; Statistical analysis; Structural analysis; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0177327

Obesity is believed to be one of the major risk factors for cardiovascular disease in Western countries. However, the effects of obesity should be continuously examined in the Japanese population because the average bodily habitus differs among countries. In this study, we collectively examined the significance of obesity and obesity-triggered risk factors including the low reactivity of B-type natriuretic peptide (BNP), for ischemic heart disease (IHD) in Japanese patients. The study patients consisted of 1252 subjects (IHD: n = 970; non-IHD: n = 282). Multiple logistic regression analysis revealed that dyslipidemia, hypertension, diabetes, and the low reactivity of BNP were significant risk factors for IHD, but body mass index (BMI) was not. A theoretical path model was proposed by positioning BMI at the top of the hierarchical model. Exploratory factor analysis revealed that BMI did not play a causative role in IHD (P = NS). BMI was causatively linked to other risk factors (P<0.001 for hypertension; P<0.001 for dyslipidemia; P<0.001 for HbA1c; P<0.001 for LogBNP), and these factors played a causative role in IHD (P<0.001 for hypertension; P<0.001 for dyslipidemia; P<0.001 for HbA1c; P<0.001 for LogBNP). The intrinsic power of the low reactivity of BNP induced by high BMI on the promotion of IHD was fairly potent. This study demonstrated that obesity per se is not a strong risk factor for IHD in Japanese patients. However, several important risk factors triggered by obesity exhibited a causative role for IHD. The low reactivity of BNP is a substantial risk factor for IHD.