根据弗雷明汉风险评分评估血管内皮功能和颈动脉内膜中层厚度的性别差异。

Sex differences between vascular endothelial function and carotid intima-media thickness by Framingham Risk Score.

机构信息

Department of Ultrasound, or Suhua Wu, MD, Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Er Rd, 510080 Guangzhou, Guangdong, China.

出版信息

J Ultrasound Med. 2014 Feb;33(2):281-6. doi: 10.7863/ultra.33.2.281.

DOI:10.7863/ultra.33.2.281

PMID:24449731

Abstract

OBJECTIVES

To investigate sex differences associated with changes in brachial artery flow-mediated dilatation and carotid intima-media thickness by Framingham Risk Score.

METHODS

The study included 1083 patients aged 30 to 80 years. According to the Framingham Risk Score, patients were divided into 3 groups: low, mid, and high risk. Traditional cardiovascular risk factors such as age, sex, smoking, diabetes, hypertension, and cholesterol were assessed by Framingham Risk Score, as well as laboratory and vascular parameters, including flow-mediated dilatation and intima-media thickness. Correlations between flow-mediated dilatation, intima-media thickness, and the Framingham Risk Score were analyzed by sex.

RESULTS

Compared with women, flow-mediated dilatation in men was significantly lower in the low-risk group (mean ± SD, 8.31% ± 2.89% versus 9.76% ± 3.62%; P< .001) but significantly higher in the mid- and high-risk groups (mid-risk, 7.43% ± 2.65% versus 6.67% ± 2.42%; high-risk, 6.41% ± 2.27% versus 5.78% ± 2.39%; P< .001). Flow-mediated dilatation decreased with an increasing Framingham Risk Score in both sexes but especially in women. Although intima-media thickness increased with the Framingham Risk Score in both sexes, there was no significant sex difference between the groups. Univariate analysis showed significant negative correlations between flow-mediated dilatation and the Framingham Risk Score in both sexes (R men = -0.308; P < .001; R women = -0.572; P < .001) and flow-mediated dilatation and intima-media thickness (R men = -0.295; P < .001; R women = -0.474; P< .001). There was a significant positive correlation between intima-media thickness and the Framingham Risk Score (R men = 0.571; P< .001; R women = 0.633; P < .001).

CONCLUSIONS

A sex difference existed only for flow-mediated dilatation at the same Framingham risk level. Flow-mediated dilatation might be more sensitive than intima-media thickness for detecting sex differences in vascular dysfunction, according to Framingham risk stratification in a Chinese population.

摘要

目的

通过弗雷明汉风险评分探讨肱动脉血流介导扩张和颈动脉内中膜厚度随弗雷明汉风险评分变化的性别差异。

方法

本研究纳入了 1083 名年龄在 30 至 80 岁之间的患者。根据弗雷明汉风险评分，患者被分为低危、中危和高危 3 组。通过弗雷明汉风险评分评估传统心血管危险因素，如年龄、性别、吸烟、糖尿病、高血压和胆固醇，以及实验室和血管参数，包括血流介导扩张和内中膜厚度。通过性别分析血流介导扩张、内中膜厚度与弗雷明汉风险评分之间的相关性。

结果

与女性相比，男性在低危组的血流介导扩张明显较低（平均值 ± 标准差，8.31%±2.89%比 9.76%±3.62%；P<0.001），而在中危和高危组明显较高（中危，7.43%±2.65%比 6.67%±2.42%；高危，6.41%±2.27%比 5.78%±2.39%；P<0.001）。血流介导扩张在两性中均随弗雷明汉风险评分的增加而降低，但在女性中尤其明显。尽管内中膜厚度在两性中均随弗雷明汉风险评分的增加而增加，但组间无显著性别差异。单因素分析显示，血流介导扩张与弗雷明汉风险评分在两性中均呈显著负相关（男性 R=−0.308；P<0.001；女性 R=−0.572；P<0.001），血流介导扩张与内中膜厚度也呈显著负相关（男性 R=−0.295；P<0.001；女性 R=−0.474；P<0.001）。内中膜厚度与弗雷明汉风险评分呈显著正相关（男性 R=0.571；P<0.001；女性 R=0.633；P<0.001）。