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[腹部肥胖对心肌梗死面积的影响]

[Effect of abdominal obesity on size of myocardial infarction].

作者信息

Iglesias Bolaños Paloma, Olivar Roldán Juana, Peñalver Talavera David, Díaz Guardiola Patricia, Vega Piñero Belén, Monereo Megías Susana

机构信息

Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Carretera de Toledo Km 12,500, 28905 Getafe, España.

出版信息

Endocrinol Nutr. 2009 Jan;56(1):4-8. doi: 10.1016/S1575-0922(09)70187-1. Epub 2009 Mar 1.

Abstract

OBJECTIVE

Metabolic syndrome consists of a group of factors that predict the risk of having an acute cardiovascular event. Some of these factors increase the risk of myocardial infarction and are also associated with the severity of cardiovascular events. The objective was to determine the influence of factors associated with metabolic syndrome, and especially abdominal obesity, on the size of coronary events, estimated by the concentration of total creatine phosphokinase (CPK) and CPK-MB isoenzyme (CPK-MB).

SUBJECTS AND METHOD

We performed a cross-sectional study of 40 men diagnosed with acute coronary syndrome. We collected clinical data (age, history of diabetes, dyslipidemia and hypertension ) and anthropometric data [body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHR)]. CPK and CPK-MB concentrations were measured to determine the maximum concentration reached in order to estimate the size of the myocardial infarction area.

RESULTS

The prevalence of metabolic syndrome was 30%. Approximately 84% of the patients were overweight and 42% had abdominal obesity. A positive association was found between myocardial enzymes and anthropometric parameters (BMI, WC, WHR). The variable showing the closest association with the size of myocardial infarction was central obesity [total CPK, r (Pearson) = 0.47; p<0.003] and (CPK-MB, r= 0.4; p<0.01). Metabolic syndrome was not a predictive factor for the size of myocardial necrosis (beta=-0.29; p<0.1). Multiple regression analysis showed that WC predicted maximal total CPK (beta=37.15; 95% CI, 9.16-65.15; p<0.01) and CPK-MB concentrations (beta=5.7; 95% CI, -0.4-11.9; p< 0.06) after an acute coronary event.

CONCLUSIONS

The presence of abdominal obesity was associated with greater myocardial necrosis size after an acute coronary event.

摘要

目的

代谢综合征由一组可预测急性心血管事件风险的因素组成。其中一些因素会增加心肌梗死风险,且与心血管事件的严重程度也相关。目的是确定与代谢综合征相关的因素,尤其是腹型肥胖,对通过总肌酸磷酸激酶(CPK)和CPK-MB同工酶(CPK-MB)浓度估算的冠状动脉事件大小的影响。

对象与方法

我们对40名诊断为急性冠状动脉综合征的男性进行了横断面研究。我们收集了临床数据(年龄、糖尿病史、血脂异常和高血压史)和人体测量数据[体重指数(BMI)、腰围(WC)和腰高比(WHR)]。测量CPK和CPK-MB浓度,以确定达到的最大浓度,从而估算心肌梗死面积大小。

结果

代谢综合征的患病率为30%。约84%的患者超重,42%有腹型肥胖。心肌酶与人体测量参数(BMI、WC、WHR)之间存在正相关。与心肌梗死面积大小显示出最密切关联的变量是中心性肥胖[总CPK,r(皮尔逊)=0.47;p<0.003]和(CPK-MB,r=0.4;p<0.01)。代谢综合征不是心肌坏死面积大小的预测因素(β=-0.29;p<0.1)。多元回归分析显示,急性冠状动脉事件后,WC可预测最大总CPK(β=37.15;95%CI,9.16-65.15;p<0.01)和CPK-MB浓度(β=5.7;95%CI,-0.4-11.9;p<0.06)。

结论

急性冠状动脉事件后腹型肥胖的存在与更大的心肌坏死面积相关。

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