Kawamoto Ryuichi, Tomita Hitomi, Ohtsuka Nobuyuki, Inoue Ai, Kamitani Atsushi
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo-city, Ehime, Japan.
J Atheroscler Thromb. 2007 Apr;14(2):78-85. doi: 10.5551/jat.14.78.
Carotid intima-media thickness (IMT) is a useful surrogate marker of cardiovascular disease and is associated with cardiac events. We investigated cross-sectionally the association between carotid intima-media thickness (IMT), confounding risk factors, and metabolic syndrome (MetS) using the modified Japanese criteria.
Carotid IMT was evaluated on B-mode ultrasonography in 918 patients (394 men aged 66 +/- 15 years and 524 women aged 72 +/- 13 years).
Among our 918 patients, 74 (8.1%) had no metabolic abnormalities, 478 (52.1%) had a metabolic abnormality with neither type 2 diabetes or MetS, and 127 had MetS without diabetes. Of the patients with type 2 diabetes, 132 (14.4%) did not have MetS and 107 (11.7%) had both type 2 diabetes and MetS. The carotid IMT values in the four groups with any metabolic abnormalities were significantly greater than the IMT of the group with neither condition (p=0.001), respectively. In syndrome model, type 2 diabetes was significantly associated with carotid atherosclerosis (p= 0.006), but MetS was borderline significant. In the component model of MetS, there was a significant association with hypertension (p<0.001) and dyslipidemia (p=0.006). Multiple logistic regression analysis for carotid atherosclerosis compared to neither condition demonstrated that subjects with both MetS and diabetes (OR, 5.58; 95% CI, 2.64-11.8), those with type 2 diabetes without MetS (OR, 3.00; 95% CI, 1.45-6.22), and those with MetS without type 2 diabetes (OR, 2.58; 75% CI, 1.24-5.39) showed a higher odds ratio after adjustment for covariates.
Even after taking into account each individual component of MetS, the clustering of visceral obesity with at least 2 of the 3 components, and diabetes are independently associated with increased carotid IMT. This suggests that the components of MetS and type 2 diabetes interact to affect vascular thickness synergistically.
颈动脉内膜中层厚度（IMT）是心血管疾病的一个有用替代标志物，且与心脏事件相关。我们使用改良的日本标准，横断面研究了颈动脉内膜中层厚度（IMT）、混杂危险因素与代谢综合征（MetS）之间的关联。
对918例患者（394名年龄66±15岁的男性和524名年龄72±13岁的女性）进行B型超声检查评估颈动脉IMT。
在我们的918例患者中，74例（8.1%）无代谢异常，478例（52.1%）有代谢异常但无2型糖尿病或代谢综合征，127例有代谢综合征但无糖尿病。在2型糖尿病患者中，132例（14.4%）无代谢综合征，107例（11.7%）既有2型糖尿病又有代谢综合征。有任何代谢异常的四组患者的颈动脉IMT值均显著高于无任何异常的组（p = 0.001）。在综合征模型中，2型糖尿病与颈动脉粥样硬化显著相关（p = 0.006），但代谢综合征接近显著。在代谢综合征的组分模型中，与高血压（p < 0.001）和血脂异常（p = 0.006）有显著关联。与无任何异常情况相比，对颈动脉粥样硬化进行多因素logistic回归分析表明，既有代谢综合征又有糖尿病的受试者（比值比，5.58；95%可信区间，2.64 - 11.8）、有2型糖尿病但无代谢综合征的受试者（比值比，3.00；95%可信区间，1.45 - 6.22）以及有代谢综合征但无2型糖尿病的受试者（比值比，2.58；75%可信区间，1.24 - 5.39）在调整协变量后显示出更高的比值比。
即使考虑到代谢综合征的各个单独组分，内脏肥胖与3个组分中至少2个组分的聚集以及糖尿病独立地与颈动脉IMT增加相关。这表明代谢综合征的组分和2型糖尿病相互作用，协同影响血管厚度。
