Vigna G B, Bolzan M, Romagnoni F, Valerio G, Vitale E, Zuliani G, Fellin R
Institute of Medical Pathology, University of Ferrara, Italy.
Circulation. 1992 Jun;85(6):2205-11. doi: 10.1161/01.cir.85.6.2205.
Different patterns of risk factors might be related to the involvement of specific vascular districts by atherosclerosis. In this sense, many investigations have addressed coronary artery disease, whereas extracoronary atherosclerosis has received less extensive attention.
Vascular risk factors, with particular attention to lipid parameters (total cholesterol [TC]; triglycerides; high density lipoprotein cholesterol [HDL-C], HDL2 and HDL3 cholesterol [HDL2-C, HDL3-C]), were evaluated by means of univariate and multivariate (discriminant) analysis in a group of 169 patients (128 men and 41 women; mean ages, 58 +/- 7 and 62 +/- 7 years, respectively) with clinically and angiographically demonstrated atherosclerosis of the supra-aortic trunk and/or lower limbs. Patients with coronary artery disease were excluded from this study. The control group consisted of 140 age- and sex-matched individuals. By univariate analysis, smoking was more closely associated with peripheral atherosclerosis, whereas blood pressure was higher in patients with supra-aortic disease. Unrecognized diabetes mellitus was a frequent finding in patients with peripheral disease. The percentage of hyperlipidemias was fourfold higher in patients than in control subjects, with differences consisting of higher triglycerides and lower HDL-C, HDL2-C, and HDL3-C concentrations. By discriminant analysis, high correct classification (CC) rates were achieved in the various patient subgroups on the basis of variables selected from the statistical function. In male patients with peripheral disease, the variables HDL-C, smoking, diastolic blood pressure, uric acid, and glucose, in that order, yielded a CC in 90.4% of the cases; in female patients, smoking, TC/HDL-C, and body mass index gave a CC rate of 95.9%. In men with cerebral disease, the selected variables TC/HDL-C, diastolic blood pressure, and TC yielded a CC of 90.7%; in women, uric acid, TC/HDL-C, and fibrinogen levels produced a CC rate of 89.2%.
Risk profiles in atherosclerosis of the supra-aortic trunks and lower limbs seem to differ in relation to gender and circulatory district involved. The importance of lipid parameters, in particular HDL-C, HDL2-C, and TC/HDL-C, as extracoronary risk factors is further confirmed.
不同模式的风险因素可能与动脉粥样硬化累及特定血管区域有关。从这个意义上讲，许多研究都针对冠状动脉疾病，而冠状动脉外的动脉粥样硬化受到的关注较少。
在一组169例患者（128例男性和41例女性；平均年龄分别为58±7岁和62±7岁）中，通过单变量和多变量（判别）分析评估血管危险因素，特别关注脂质参数（总胆固醇[TC]；甘油三酯；高密度脂蛋白胆固醇[HDL-C]、HDL2和HDL3胆固醇[HDL2-C、HDL3-C]），这些患者临床上和血管造影显示有主动脉弓上干和/或下肢动脉粥样硬化。本研究排除了冠状动脉疾病患者。对照组由140名年龄和性别匹配的个体组成。通过单变量分析，吸烟与外周动脉粥样硬化的相关性更强，而主动脉弓疾病患者的血压更高。未被识别的糖尿病在周围血管疾病患者中很常见。患者中高脂血症的百分比是对照组的四倍，差异在于甘油三酯更高，HDL-C、HDL2-C和HDL3-C浓度更低。通过判别分析，根据从统计函数中选择的变量，在各个患者亚组中都实现了较高的正确分类（CC）率。在患有外周血管疾病的男性患者中，变量HDL-C、吸烟、舒张压、尿酸和血糖依次在90.4%的病例中产生了CC；在女性患者中，吸烟、TC/HDL-C和体重指数的CC率为95.9%。在患有脑部疾病的男性中，选择的变量TC/HDL-C、舒张压和TC产生了90.7%的CC；在女性中，尿酸、TC/HDL-C和纤维蛋白原水平产生了89.2%的CC率。
主动脉弓上干和下肢动脉粥样硬化的风险特征似乎因性别和所累及的循环区域而异。脂质参数，特别是HDL-C、HDL2-C和TC/HDL-C作为冠状动脉外危险因素的重要性得到了进一步证实。
