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Visceral adipose tissue has emerged as a key organ contributing to the development of coronary artery disease (CAD). However, defining central obesity by waist circumference (WC) may underestimate visceral adiposity in lean patients. The aim of this study was to investigate the relationship between visceral adiposity and severity of CAD in subjects with normal WC.Among 365 patients with documented CAD, 90 male subjects with normal WC (90 cm) were selected and their visceral fat areas (VFA) were examined using computed tomography. Lipid profiles and levels of adipokines including lipocalin-2, high molecular weight adiponectin, and monocyte chemoattractant protein (MCP)-1 were measured. Patients were divided into tertiles based on VFA at the L4 vertebra level.Patients with single-vessel disease had significantly lower VFA than those with multi-vessel disease (P0.05; 86.0 vs. 97.5 vs. 99.6 cm(2) for single- , double- , and triple-vessel diseases, respectively). Positive association between the extent of CAD and VFA was clearly demonstrated and logistic regression analysis showed that subjects in the upper tertile for VFA had a 4.5-fold higher risk of having multi-vessel disease compared with those in the lowest tertile (P0.05; odds ratio=4.51; 95% confidence interval=1.10-18.45). Circulating levels of lipocalin-2 and MCP-1 were significantly higher in the upper tertiles of VFA.Increased visceral adiposity is significantly associated with the severity of CAD, even in subjects without central obesity as determined by WC measurements. Abnormalities in adipokine regulation may provide a novel mechanistic connection between visceral adiposity and associated cardiovascular complications.

Background and aims: The patient with hepatocellular carcinoma (HCC) diagnosed for the first time was gradually older year by year in spite of the etiology in Japan. Recently the HCC naive patients diagnosed at the age over 80 years old were not rarely found. In that case, the indication of the treatment of patient with HCC was supposed to be difficult due to the liver function and their complication. The aim of this study was to assess the liver function and the prognosis of its treatment of the naive patient with HCC over 80years old. Methods: During 8years(2001~2008), 538patients (203woman and 335man) had been diagnosed for the first time as HCC by ultrasonograpy, computed tomography and magnetic resonance imaging and admitted to our hospital for the treatment. These patients were examined blood test and were performed thepatic resection, percutanous radiofrequency ablation (RFA), transcatheter chemoemblization (TACE) or conservative treatment. We classified the patients in two groups, group A: =80 years old, according to the age diagnosed for the first time, and assessed the clinical data between two groups. Results: Forty subjects (22woman and 18man, HBV:HCV:NBNC=3:28:9) out of 538HCC naive patients (7.4%, HBV:HCV:NBNC=82:383:73) were over 80years old. Women and NBNC cases were more found in the group B (p