Department of "Biomedicina Clinica e Molecolare", University of Catania, Garibaldi Hospital Catania, Italy.
Atherosclerosis. 2012 Aug;223(2):458-62. doi: 10.1016/j.atherosclerosis.2012.05.008. Epub 2012 Jun 7.
We investigated the separate impact of metabolic syndrome (MS) and altered glucose tolerance on early markers of vascular injuries.
Intima-media thickness (IMT) and pulse wave analysis (PWA), were evaluated in 132 overweight or obese subjects, with (MS(+)) or without (MS(-)) MS; subjects were further classified as normotolerant (NT) or with altered glucose tolerance (AGT) according to a 2 h oral glucose tolerance test (OGTT).
In MS(+) patients, IMT was higher than in the MS(-) group, and PWA revealed higher augmentation pressure (Aug, the contribution that wave reflection makes to systolic arterial pressure) and lower subendocardial viability ratio (SEVR, an estimate of myocardial perfusion). When analyzed according to glucose tolerance, IMT was higher in MS(+)NT subjects and AGT patients with and without MS, vs. MS(-)NT subjects. Logistic regression modeling showed that both AGT and MS were independently associated with increased IMT. However, only MS remained associated with IMT after adjustment for age. SEVR was reduced only in MS(+) patients, independently of glucose tolerance. In both groups, Aug and AugI were higher in the AGT group, but the correlation with 2 h-plasma glucose disappeared when corrected for age.
Both MS and AGT altered IMT, but the effect of AGT disappears when age is added to the multiple regression model. In contrast, arterial stiffness was affected differently in the two categories: in subjects with MS, the subendocardial viability ratio (an estimate of myocardial perfusion) was impaired, while in subjects with AGT, both Aug and AugI were increased. These data suggest that applying the definition of MS might help to better characterize cardiovascular risk in subjects with altered glucose tolerance or obesity.
我们研究了代谢综合征（MS）和葡萄糖耐量改变对血管损伤早期标志物的单独影响。
在 132 名超重或肥胖者中评估了内-中膜厚度（IMT）和脉搏波分析（PWA），这些患者分为有（MS（+））或无（MS（-））MS；根据 2 小时口服葡萄糖耐量试验（OGTT），将患者进一步分为正常糖耐量（NT）或葡萄糖耐量改变（AGT）。
在 MS（+）患者中，IMT 高于 MS（-）组，PWA 显示更高的增强压（Aug，波反射对收缩压的贡献）和更低的心内膜下活力比（SEVR，心肌灌注的估计）。当根据葡萄糖耐量进行分析时，MS（+）NT 患者和 MS（+）伴或不伴 AGT 的患者的 IMT 高于 MS（-）NT 患者。Logistic 回归模型显示，AGT 和 MS 均与 IMT 增加独立相关。然而，只有 MS 在调整年龄后与 IMT 相关。仅在 MS（+）患者中，SEVR 降低，与葡萄糖耐量无关。在两组中，AGT 组的 Aug 和 AugI 均升高，但当校正年龄时，与 2 小时血浆葡萄糖的相关性消失。
MS 和 AGT 均改变了 IMT，但当在多元回归模型中加入年龄时，AGT 的影响消失。相比之下，在这两种情况下，动脉僵硬度受到不同的影响：在 MS 患者中，心内膜下活力比（心肌灌注的估计）受损，而在 AGT 患者中，Aug 和 AugI 均增加。这些数据表明，应用 MS 的定义可能有助于更好地描述葡萄糖耐量改变或肥胖患者的心血管风险。
