体重变化和肥胖预示着绝经后女性静息和内皮依赖性心肌血流受损。
Weight changes and obesity predict impaired resting and endothelium-dependent myocardial blood flow in postmenopausal women.
作者信息
Martin Julie W, Briesmiester Kerri, Bargardi Anita, Muzik Orro, Mosca Lori, Duvernoy Claire S
机构信息
Cardiology Division, University of Michigan, Ann Arbor, Michigan, USA.
出版信息
Clin Cardiol. 2005 Jan;28(1):13-8. doi: 10.1002/clc.4960280105.
BACKGROUND
Obesity has been associated with impaired endothelial function, but the influence of lifetime weight patterns on endothelial function has not been studied.
HYPOTHESIS
We hypothesized that coronary vascular reactivity would be diminished in postmenopausal women with a history of obesity and frequent weight swings.
METHODS
We performed dynamic N-13 ammonia positron emission tomography in 18 postmenopausal women with cardiac risk factors. Myocardial blood flow (MBF) was measured at rest, after the cold pressor test (CPT), and after adenosine infusion in order to determine baseline and endothelium-dependent and -independent flows, respectively. Myocardial blood flow was corrected for cardiac work by normalizing to the rate-pressure product. Weight history was obtained by standardized questionnaire.
RESULTS
Normalized rest (n-rest) MBF correlated negatively with current weight (r = -0.52, p = 0.026) and weight at age 18 (r = -0.47, p = 0.047). Normalized CPT (n-CPT) MBF correlated inversely with current weight (r = -0.55, p = 0.018), weight at age 18 (r = -0.605, p = 0.008), and highest weight (r = -0.62, p = 0.006). Higher waist circumference predicted lower n-rest MBF (r = -0.52, p = 0.028) and n-CPT MBF (r = -0.48, p = 0.04). The same association was found with hip circumference (r = -0.52, p = 0.028; r = -0.49, p = 0.038, respectively), whereas higher body mass index (BMI) predicted lower n-CPT MBF (r = -0.53, p = 0.02). Women with at least four significant weight swings had lower MBF during rest, CPT, and n-CPT (0.88 vs. 1.19 ml/g/min, p = 0.008; 0.76 vs. 1.23 ml/g/min, p < 0.001; 0.74 vs. 1.10 ml/g/min, p = 0.009, respectively).
CONCLUSIONS
Increased waist and hip circumference, weight, and frequent weight swings are associated with impaired resting and endothelium-dependent MBF in postmenopausal women. These data suggest that lifetime weight patterns may influence cardiovascular risk in women.
背景
肥胖与内皮功能受损有关，但终生体重模式对内皮功能的影响尚未得到研究。
假设
我们假设，有肥胖病史且体重频繁波动的绝经后女性，其冠状血管反应性会降低。
方法
我们对18名有心脏危险因素的绝经后女性进行了动态N - 13氨正电子发射断层扫描。在静息状态、冷加压试验（CPT）后以及腺苷输注后测量心肌血流量（MBF），以分别确定基线血流量以及内皮依赖性和非内皮依赖性血流量。通过将心肌血流量标准化为心率 - 血压乘积来校正心脏做功。通过标准化问卷获取体重史。
结果
标准化静息（n - rest）MBF与当前体重（r = -0.52，p = 0.026）和18岁时体重（r = -0.47，p = 0.047）呈负相关。标准化CPT（n - CPT）MBF与当前体重（r = -0.55，p = 0.018）、18岁时体重（r = -0.605，p = 0.008）和最高体重（r = -0.62，p = 0.006）呈负相关。较高的腰围预示着较低的n - rest MBF（r = -0.52，p = 0.028）和n - CPT MBF（r = -0.48，p = 0.04）。臀围也有同样的相关性（分别为r = -0.52，p = 0.028；r = -0.49，p = 0.038），而较高的体重指数（BMI）预示着较低的n - CPT MBF（r = -0.53，p = 0.02）。至少有四次显著体重波动的女性在静息、CPT和n - CPT期间的MBF较低（分别为0.88 vs. 1.19 ml/g/min，p = 0.008；0.76 vs. 1.23 ml/g/min，p < 0.001；0.74 vs. 1.10 ml/g/min，p = 0.009）。
结论
腰围、臀围增加、体重增加以及频繁的体重波动与绝经后女性静息和内皮依赖性MBF受损有关。这些数据表明，终生体重模式可能会影响女性的心血管风险。
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