通过EZSCAN评估的自主神经功能障碍和亚临床动脉粥样硬化。

Autonomic dysfunction assessed by EZSCAN and subclinical atherosclerosis.

作者信息

Sun Jichao, Zhang Yinfei, Xu Baihui, Lv Xiaofei, Ding Lin, Chen Ying, Sun Wanwan, Lu Jieli, Xu Min, Bi Yufang, Ning Guang

机构信息

Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, E-Institute of Shanghai Universities, Shanghai, China; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Laboratory of Endocrine and Metabolic Diseases, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Shanghai, China.

出版信息

J Diabetes. 2014 Sep;6(5):409-16. doi: 10.1111/1753-0407.12135. Epub 2014 Mar 27.

DOI:10.1111/1753-0407.12135

PMID:24506497

Abstract

BACKGROUND

The present study aimed to explore the association between autonomic dysfunction and measurements of atherosclerosis in a middle-aged and elderly Chinese population.

METHODS

A population-based cross-sectional study was performed in Shanghai, China, from March to August 2010, with 5076 participants included in the analysis. Autonomic function was assessed by a novel EZSCAN test based on sudomotor function analysis. Carotid intima-media thickness (CIMT) was measured using B-mode ultrasonography and brachial-ankle pulse wave velocity (ba-PWV) was measured using an autonomic device. Participants were divided into three groups based on EZSCAN values: Group 1: EZSCAN 0-24; Group 2, EZSCAN 25-49; and Group 3, EZSCAN 50-100. These groups denoted autonomic dysfunction risk groups as follows: no risk, moderate risk and high risk, respectively.

RESULTS

The prevalence of elevated CIMT and ba-PWV increased markedly with increasing EZSCAN values (elevated CIMT 7.4%, 17.5%, and 29.7%, elevated ba-PWV 3.2%, 19.7%, and 36.5%, in Groups 1, 2, and 3, respectively; both Ptrend < 0.0001). Logistic regressions revealed that EZSCAN values ≥50 were associated with a non-significantly higher risk of elevated CIMT (odds ratio [OR] = 1.43; 95% confidence interval [CI] 0.98-2.07) and a significantly higher risk of elevated ba-PWV (OR = 2.16; 95% CI 1.25-3.71) compared with EZSCAN values <25, after controlling for conventional risk factors.

CONCLUSION

A higher EZSCAN value (≥50), an index of high autonomic dysfunction risk, was associated with an increased risk of elevated ba-PWV and CIMT. Such associations were partially explained by traditional atherosclerotic risk factors.

摘要

背景

本研究旨在探讨中国中老年人群中自主神经功能障碍与动脉粥样硬化测量指标之间的关联。

方法

2010年3月至8月在中国上海进行了一项基于人群的横断面研究，5076名参与者纳入分析。基于汗腺运动功能分析，通过新型EZSCAN测试评估自主神经功能。使用B型超声测量颈动脉内膜中层厚度（CIMT），并使用自主神经功能检测设备测量臂踝脉搏波速度（ba-PWV）。根据EZSCAN值将参与者分为三组：第1组：EZSCAN 0 - 24；第2组，EZSCAN 25 - 49；第3组，EZSCAN 50 - 100。这些组分别表示自主神经功能障碍风险组如下：无风险、中度风险和高风险。

结果

随着EZSCAN值增加，CIMT升高和ba-PWV升高的患病率显著增加（第1组、第2组和第3组中CIMT升高分别为7.4%、17.5%和29.7%，ba-PWV升高分别为3.2%、19.7%和36.5%；两者Ptrend均<0.0001）。逻辑回归显示，在控制传统风险因素后，与EZSCAN值<25相比，EZSCAN值≥50与CIMT升高风险非显著升高相关（比值比[OR]=1.43；95%置信区间[CI]0.98 - 2.．07），与ba-PWV升高风险显著升高相关（OR = 2.16；95% CI 1.25 - 3.71）。