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肥胖患者中各种肥胖测量指标与动脉僵硬度的关系。

The relationship between various measures of obesity and arterial stiffness in morbidly obese patients.

机构信息

Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway.

出版信息

BMC Cardiovasc Disord. 2011 Feb 1;11:7. doi: 10.1186/1471-2261-11-7.

Abstract

BACKGROUND

Obesity is associated with increased risk of cardiovascular disease. Arterial stiffness assessed by carotid femoral pulse wave velocity (PWV) is an independent predictor of cardiovascular morbidity and mortality. We aimed to investigate how various measures of body composition affect arterial stiffness.

METHODS

This is an analysis of cross-sectional baseline data from a controlled clinical trial addressing changes in arterial stiffness after either surgery or lifestyle intervention in a population of morbidly obese patients. High-fidelity applanation tonometry (Millar, Sphygmocor) was used to measure pulse wave velocity (PWV). Carotid femoral PWV is a direct measure of arterial stiffness and is considered to be the gold standard method. The Inbody 720 Body Composition Analyzer was used for bioelectrical impedance analysis (BIA). Spearman's correlation, independent samples t-test, chi-square tests, Fisher's exact test and multiple linear regression analyses were used as statistical methods.

RESULTS

A total of 133 patients (79 women), with a mean (SD) age of 43 (11) years were included in the study. Men had a significantly higher prevalence of obesity related comorbidities and significantly higher PWV, 9.1 (2.0) m/s vs. 8.1 (1.8) m/s, p = 0.003, than women. In the female group, PWV was positively correlated with WC, WHtR, BMI and visceral fat area. In the male group, PWV was negatively correlated with BMI. Multiple linear regression analysis showed that increasing BMI, WC, WHtR, visceral fat area and fat mass were independently associated with higher PWV in women, but not in men, after adjustment for age, hypertension and type 2 diabetes.

CONCLUSION

Most measures of general and abdominal obesity were predictors of arterial stiffness in female morbidly obese patients.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier NCT00626964.

摘要

背景

肥胖与心血管疾病风险增加相关。通过颈动脉-股动脉脉搏波速度(PWV)评估的动脉僵硬度是心血管发病率和死亡率的独立预测因子。我们旨在研究身体成分的各种指标如何影响动脉僵硬度。

方法

这是一项针对病态肥胖患者接受手术或生活方式干预后动脉僵硬度变化的对照临床试验的横断面基线数据的分析。高保真平板张力测量法(Millar,Sphygmocor)用于测量脉搏波速度(PWV)。颈动脉-股动脉 PWV 是动脉僵硬度的直接测量指标,被认为是金标准方法。Inbody 720 身体成分分析仪用于生物电阻抗分析(BIA)。采用 Spearman 相关、独立样本 t 检验、卡方检验、Fisher 确切检验和多元线性回归分析作为统计学方法。

结果

共有 133 名患者(79 名女性)纳入研究,平均(标准差)年龄为 43(11)岁。男性肥胖相关合并症的患病率明显更高,且 PWV 显著更高,为 9.1(2.0)m/s 比 8.1(1.8)m/s,p=0.003。在女性组中,PWV 与 WC、WHtR、BMI 和内脏脂肪面积呈正相关。在男性组中,PWV 与 BMI 呈负相关。多元线性回归分析显示,在调整年龄、高血压和 2 型糖尿病后,女性 BMI、WC、WHtR、内脏脂肪面积和脂肪质量的增加与 PWV 升高独立相关,但在男性中则无此相关性。

结论

大多数一般和腹部肥胖指标是女性病态肥胖患者动脉僵硬度的预测因子。

试验注册

ClinicalTrials.gov 标识符 NCT00626964。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00de/3042421/d6f897efd73c/1471-2261-11-7-1.jpg

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