Scuteri Angelo, Najjar Samer S, Muller Denis C, Andres Reubin, Hougaku Hidetaka, Metter E Jeffrey, Lakatta Edward G
Laboratory of Cardiovascular Science, Laboratory of Clinical Investigation, Gerontology Research Center, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland 21224-6825, USA.
J Am Coll Cardiol. 2004 Apr 21;43(8):1388-95. doi: 10.1016/j.jacc.2003.10.061.
We sought to evaluate whether the clustering of multiple components of the metabolic syndrome (MS) has a greater impact on these vascular parameters than individual components of MS.
Intima-media thickness (IMT) and vascular stiffness have been shown to be independent predictors of adverse cardiovascular events. The MS is defined as the clustering of three or more of the cardiovascular risk factors of dysglycemia, hypertension, dyslipidemia, and obesity.
Carotid IMT and stiffness were derived via B-mode ultrasonography in 471 participants from the Baltimore Longitudinal Study on Aging, who were without clinical cardiovascular disease and not receiving antihypertensive therapy.
The MS conferred a disproportionate increase in carotid IMT (+16%, p < 0.0001) and stiffness (+32%, p < 0.0001), compared with control subjects. Multiple regression models, which included age, gender, smoking, low-density lipoprotein, as well as each individual component of MS as continuous variables, showed that MS was an independent determinant of both IMT (p = 0.002) and stiffness (p = 0.012). The MS was associated with a greater prevalence of subjects whose values were in the highest quartiles of IMT, stiffness, or both.
Even after taking into account each individual component of MS, the clustering of at least three of these components is independently associated with increased IMT and stiffness. This suggests that the components of MS interact to synergistically impact vascular thickness and stiffness. Future studies should examine whether the excess cardiovascular risk associated with MS is partly mediated through the amplified alterations in these vascular properties.
我们试图评估代谢综合征(MS)多个组分的聚集对这些血管参数的影响是否比MS的单个组分更大。
内膜中层厚度(IMT)和血管僵硬度已被证明是不良心血管事件的独立预测因素。MS被定义为血糖异常、高血压、血脂异常和肥胖这三种或更多心血管危险因素的聚集。
在巴尔的摩纵向衰老研究的471名参与者中,通过B型超声检查得出颈动脉IMT和僵硬度,这些参与者无临床心血管疾病且未接受抗高血压治疗。
与对照受试者相比,MS使颈动脉IMT增加幅度不成比例(+16%,p<0.0001),僵硬度增加幅度也不成比例(+32%,p<0.0001)。多元回归模型将年龄、性别、吸烟、低密度脂蛋白以及MS的每个单独组分作为连续变量纳入,结果显示MS是IMT(p=0.002)和僵硬度(p=0.012)的独立决定因素。MS与IMT、僵硬度或两者处于最高四分位数的受试者患病率更高相关。
即使考虑到MS的每个单独组分,这些组分中至少三个的聚集仍与IMT增加和僵硬度增加独立相关。这表明MS的组分相互作用,协同影响血管厚度和僵硬度。未来的研究应检查与MS相关的额外心血管风险是否部分通过这些血管特性的放大改变介导。