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全景X线片上颈动脉粥样斑块在隐匿性代谢综合征诊断中的意义

The significance of carotid artery atheromas on panoramic radiographs in the diagnosis of occult metabolic syndrome.

作者信息

Friedlander Arthur H, Golub Michael S

机构信息

Graduate Medical Education, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jan;101(1):95-101. doi: 10.1016/j.tripleo.2005.04.027.

Abstract

OBJECTIVE

Metabolic syndrome (MetS), the co-occurrence of abdominal obesity, hypertriglyceridemia, reduced HDL cholesterol, hypertension, and insulin resistance promotes carotid atherosclerosis and stroke. The objective of this study was to determine if the presence of calcified atheromas detected on panoramic radiographs of individuals free of overt vascular disease may herald occult MetS.

STUDY DESIGN

Ninety-four individuals (mean age 65.6 years) with a calcified atheroma detected by a VA dental clinic were evaluated. A like-aged group was used for comparative analysis.

RESULTS

Fifteen percent of individuals (mean age 64 years) with an atheroma had occult MetS. Mean waist circumference was 116 cm, BMI 32.7 kg/m2, triglycerides 250 mg/dL, HDL cholesterol 35 mg/dL, blood pressure 147/87 mm Hg, and glucose 117 mg/dL. Only 6% of controls had occult MetS but this difference in prevalence was not proven to be statistically significant (P = .059).

CONCLUSION

Some individuals with a calcified atheroma may have undiagnosed MetS and should be referred to their physician because aggressive management may preclude a stroke.

摘要

目的

代谢综合征(MetS),即腹型肥胖、高甘油三酯血症、高密度脂蛋白胆固醇降低、高血压和胰岛素抵抗同时出现,会促进颈动脉粥样硬化和中风。本研究的目的是确定在无明显血管疾病的个体全景X线片上检测到的钙化动脉粥样硬化斑块是否预示着隐匿性代谢综合征。

研究设计

对94名由退伍军人事务部牙科诊所检测出有钙化动脉粥样硬化斑块的个体(平均年龄65.6岁)进行评估。使用一个年龄相仿的组进行对比分析。

结果

有动脉粥样硬化斑块的个体中15%(平均年龄64岁)患有隐匿性代谢综合征。平均腰围为116厘米,体重指数为32.7千克/平方米,甘油三酯为250毫克/分升,高密度脂蛋白胆固醇为35毫克/分升,血压为147/87毫米汞柱,血糖为117毫克/分升。对照组中只有6%患有隐匿性代谢综合征,但这种患病率差异未被证明具有统计学意义(P = 0.059)。

结论

一些有钙化动脉粥样硬化斑块的个体可能患有未被诊断出的代谢综合征,应转诊给医生,因为积极治疗可能预防中风。

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