Zhe Xing-wei, Zeng Jing, Tian Xin-kui, Chen Wei, Gu Yue, Cheng Li-tao, Chen Hui-min, Axelsson Jonas, Lindholm Bengt, Wang Tao
Division of Nephrology, Peking University Third Hospital, Beijing, PR China.
Am J Nephrol. 2008;28(4):641-6. doi: 10.1159/000117813. Epub 2008 Feb 21.
Overall, the proportion of deaths due to cardiovascular disease (CVD) reached 40-50% in dialysis patients. Pulse wave velocity (PWV) reflects arterial stiffness and may provide an integrated index of vascular status and CVD risk. Individual components of the metabolic syndrome (MetS) are well-established cardiovascular risk factors. Thus we conducted a cross-sectional study in continuous ambulatory peritoneal dialysis (CAPD) patients to explore the association of MetS components with PWV.
Prevalent CAPD patients (n = 148, 63 M/85 F) were categorized according to the number of traits of the MetS into one of three groups (No MetS, Risk of MetS, MetS). Due to the effect of peritoneal dialysis (PD), waist circumference was not assessed. Aortic stiffness was assessed by carotid-femoral PWV (C-F PWV).
Patients' MetS trait numbers were positively associated with C-F PWV (r = 0.301, p < 0.01), pulse pressure (r = 0.256, p < 0.01), systolic blood pressure (r = 0.233, p < 0.01), and serum albumin (r = 0.205, p < 0.05). In a multivariate regression analysis, PWV was independently determined by age (p < 0.01) and MetS score (p = 0.01). Adjusted R(2) of the model was 0.24.
MetS traits were closely associated with an increased C-F PWV, even after adjustment for confounders. This suggests that commonly recognized MetS criteria are useful also when predicting CVD in CAPD patients.
总体而言,透析患者中因心血管疾病(CVD)导致的死亡比例达到40%-50%。脉搏波速度(PWV)反映动脉僵硬度,可能提供血管状态和CVD风险的综合指标。代谢综合征(MetS)的各个组成部分都是公认的心血管危险因素。因此,我们对持续性非卧床腹膜透析(CAPD)患者进行了一项横断面研究,以探讨MetS各组成部分与PWV之间的关联。
将现患CAPD患者(n = 148,63名男性/85名女性)根据MetS特征数量分为三组之一(无MetS、MetS风险、MetS)。由于腹膜透析(PD)的影响,未评估腰围。通过颈股PWV(C-F PWV)评估主动脉僵硬度。
患者的MetS特征数量与C-F PWV(r = 0.301,p < 0.01)、脉压(r = 0.256,p < 0.01)、收缩压(r = 0.233,p < 0.01)和血清白蛋白(r = 0.205,p < 0.05)呈正相关。在多变量回归分析中,PWV由年龄(p < 0.01)和MetS评分(p = 0.01)独立决定。模型的调整R²为0.24。
即使在调整混杂因素后,MetS特征仍与C-F PWV升高密切相关。这表明,在预测CAPD患者的CVD时,公认的MetS标准也很有用。