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识别心血管代谢风险:内脏脂肪指数与甘油三酯/高密度脂蛋白胆固醇比值。

Identification of cardiometabolic risk: visceral adiposity index versus triglyceride/HDL cholesterol ratio.

机构信息

Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina.

Hospital Universitario General San Martín, La Plata, Buenos Aires, Argentina.

出版信息

Am J Med. 2014 Feb;127(2):152-7. doi: 10.1016/j.amjmed.2013.10.012. Epub 2013 Nov 1.

Abstract

BACKGROUND

The plasma concentration ratio of triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) can identify cardiometabolic risk and cardiovascular disease. The visceral adiposity index is a sex-specific index, in which measurements of body mass index and waist circumference are combined with TG and HDL-C concentrations. The current analysis was initiated to see if the visceral adiposity index would improve the ability of the TG/HDL-C to identify increased cardiometabolic risk and outcome.

METHODS

Cardiometabolic data were obtained in 2003 from 926 apparently healthy individuals, 796 of whom were evaluated in 2012 for evidence of incident cardiovascular disease. The relationship between TG/HDL-C and values for visceral adiposity index was evaluated by Pearson's correlation coefficient. The relative risks for first cardiovascular event between individuals above and below the TG/HDL-C sex-specific cut points, and in the top quartile of visceral adiposity index versus the remaining 3 quartiles, were estimated using Cox proportional hazard models.

RESULTS

TG/HDL-C concentration and visceral adiposity index were highly correlated (r = 0.99) in both men and women. Although more men (133 vs121) and women (73 vs 59) were identified as being at "high risk" by an elevated TG/HDL-C ratio, the individual cardiometabolic risk factors were essentially identical with either index used. However, the hazard ratio of developing cardiovascular disease was significantly increased in individuals with an elevated TG/HDL-C, whereas it was not the case when the visceral adiposity index was used to define "high risk."

CONCLUSION

The visceral adiposity index does not identify individuals with an adverse cardiometabolic profile any better than the TG/HDL-C.

摘要

背景

甘油三酯(TG)/高密度脂蛋白胆固醇(HDL-C)的血浆浓度比值可以识别心脏代谢风险和心血管疾病。内脏脂肪指数是一个性别特异性指数,其中体重指数和腰围的测量值与 TG 和 HDL-C 浓度相结合。目前的分析旨在观察内脏脂肪指数是否能提高 TG/HDL-C 识别增加的心脏代谢风险和结果的能力。

方法

2003 年从 926 名看似健康的个体中获得了心脏代谢数据,其中 796 名个体在 2012 年评估了心血管疾病的发病情况。通过 Pearson 相关系数评估了 TG/HDL-C 与内脏脂肪指数之间的关系。使用 Cox 比例风险模型估计了 TG/HDL-C 性别特异性切点以上和以下个体以及内脏脂肪指数最高四分位数与其余 3 个四分位数之间首次心血管事件的相对风险。

结果

在男性和女性中,TG/HDL-C 浓度与内脏脂肪指数高度相关(r=0.99)。尽管更多的男性(133 名比 121 名)和女性(73 名比 59 名)因 TG/HDL-C 比值升高而被认为处于“高风险”状态,但两种指数使用时,个体心脏代谢风险因素基本相同。然而,当使用 TG/HDL-C 来定义“高风险”时,发生心血管疾病的风险比显著增加,而当使用内脏脂肪指数时则不然。

结论

内脏脂肪指数不能比 TG/HDL-C 更好地识别具有不良心脏代谢特征的个体。

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