Fasanmade Olufemi A, Odeniyi Ifedayo A, Amira Christiana O, Okubadejo Njideka U
Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria.
Niger Med J. 2013 Nov;54(6):402-7. doi: 10.4103/0300-1652.126296.
We explored the relationship between anthropometric indices (obesity and abdominal adiposity) and the presence of an atherogenic lipid profile in Nigerians with major cardiovascular risk factors (type 2 diabetes mellitus-T2DM, hypertension-HBP, and concomitant disease).
Using a prospective design, 278 patients with T2DM, HBP, or concomitant disease, attending out-patient diabetes and hypertension clinics at a tertiary institution in Nigeria were evaluated. All patients were cholesterol-lowering oral medication naοve. Demographic and clinical data and anthropometric measurements were documented. Fasting lipid profiles were measured in all cases. The cut-off points for defining dyslipidaemia were: Elevated total cholesterol (TC) (mg/dL) ≥200, elevated low-density lipoprotein cholestrol (LDL-C) (mg/dL) ≥100, low high-density lipoprotein cholesterol (HDL-C) (mg/dL) <40 for men and <50 for women, and high triglycerides (TG) (mg/dL) ≥150 mg/dL.
We found a significantly higher mean BMI (kg/m(2)) in the HBP group (30.5 ± 6.0) compared to T2DM (28.1 ± 5.9) and concomitant HBP and T2DM groups (29.4 ± 5.2) (ANOVA; P = 0.02). The most frequent dyslipidaemia was elevated LDL-C in 92 (96.8%) HBP, 73 (85.9%) T2DM and 79 (80.6%) concomitant disease. The frequency of low HDL-C was highest in T2DM (68.2%) compared to the other 2 groups (P = 0.03).
Only TG levels were found to relate with any anthropometric index (waist circumference (WC) in this case) in Nigerians with major cardiovascular risk factors in this study. Routine anthropometric indices do not appear to be reliable surrogates for atherogenicity measured by abnormalities in TC, LDL-C and HDL-C.
我们探讨了人体测量指标(肥胖和腹部肥胖)与患有主要心血管危险因素(2型糖尿病-T2DM、高血压-HBP及合并疾病)的尼日利亚人动脉粥样硬化性血脂异常情况之间的关系。
采用前瞻性设计,对在尼日利亚一家三级医疗机构的门诊糖尿病和高血压诊所就诊的278例患有T2DM、HBP或合并疾病的患者进行评估。所有患者均未服用过降胆固醇口服药物。记录人口统计学和临床数据以及人体测量指标。对所有病例测量空腹血脂谱。定义血脂异常的切点为:总胆固醇(TC)升高(mg/dL)≥200,低密度脂蛋白胆固醇(LDL-C)升高(mg/dL)≥100,男性高密度脂蛋白胆固醇(HDL-C)降低(mg/dL)<40,女性<50,以及甘油三酯(TG)升高(mg/dL)≥150 mg/dL。
我们发现,与T2DM组(28.1±5.9)和合并HBP与T2DM组(29.4±5.2)相比,HBP组的平均体重指数(kg/m²)显著更高(30.5±6.0)(方差分析;P = 0.02)。最常见的血脂异常是LDL-C升高,HBP组有92例(96.8%),T2DM组有73例(85.9%),合并疾病组有79例(80.6%)。与其他两组相比,T2DM组HDL-C降低的频率最高(68.2%)(P = 0.03)。
在本研究中,患有主要心血管危险因素的尼日利亚人中,仅发现TG水平与任何人体测量指标(在本病例中为腰围(WC))有关。常规人体测量指标似乎并非通过TC、LDL-C和HDL-C异常来衡量的动脉粥样硬化性的可靠替代指标。