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腰围可以反映出脑瘫成年人的许多心血管代谢风险因素。

Waist circumference provides an indication of numerous cardiometabolic risk factors in adults with cerebral palsy.

机构信息

School of Medicine, Trinity College Dublin, Ireland.

Department of Biochemistry, St James's Hospital, Dublin, Ireland.

出版信息

Arch Phys Med Rehabil. 2014 Aug;95(8):1540-6. doi: 10.1016/j.apmr.2014.03.029. Epub 2014 Apr 15.

Abstract

OBJECTIVE

To report the prevalence of cardiometabolic risk factors in a cohort of adults with cerebral palsy (CP) and to investigate the ability of anthropometric measures to predict these factors.

DESIGN

Cross-sectional study.

SETTING

Testing took place in a laboratory setting.

PARTICIPANTS

Adults with CP (N=55; mean age, 37.5±13.3 y; Gross Motor Function Classification System levels, I-V) participated in this study.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, and C-reactive protein levels were measured from a fasting venous blood sample. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA-IR) index. Blood pressure, body mass index (BMI), waist circumference (WC), waist-hip ratio, and waist-height ratio were also measured. The metabolic syndrome (MetS) was defined according to the 2009 Joint Interim Statement.

RESULTS

The prevalence of the MetS was 20.5% in ambulatory adults and 28.6% in nonambulatory adults. BMI was associated with HOMA-IR only (β=.451; P<.01). WC was associated with HOMA-IR (β=.480; P<.01), triglycerides (β=.450; P<.01), and systolic blood pressure (β=.352; P<.05). Receiver operating characteristic curve analysis revealed that WC provided the best indication of hypertensive blood pressure, dyslipidemia, HOMA-IR, and the presence of multiple risk factors (area under the curve, .713-.763).

CONCLUSIONS

A high prevalence of the MetS was observed in this relatively young sample of adults with CP. WC was a better indicator of a number of risk factors than was BMI and presents as a clinically useful method of screening for cardiometabolic risk among adults with CP.

摘要

目的

报告脑性瘫痪(CP)成人队列中心血管代谢危险因素的流行情况,并探讨人体测量指标预测这些因素的能力。

设计

横断面研究。

地点

测试在实验室环境中进行。

参与者

本研究纳入了 55 名 CP 成人(平均年龄 37.5±13.3 岁;Gross Motor Function Classification System 分级,I-V)。

干预措施

无。

主要观察指标

从空腹静脉血样中测量总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、葡萄糖、胰岛素和 C 反应蛋白水平。使用稳态模型评估(HOMA-IR)指数计算胰岛素抵抗。还测量血压、体重指数(BMI)、腰围(WC)、腰臀比和腰高比。根据 2009 年联合临时声明定义代谢综合征(MetS)。

结果

在有活动能力的成年人中,MetS 的患病率为 20.5%,在无活动能力的成年人中为 28.6%。BMI 仅与 HOMA-IR 相关(β=.451;P<.01)。WC 与 HOMA-IR(β=.480;P<.01)、甘油三酯(β=.450;P<.01)和收缩压(β=.352;P<.05)相关。受试者工作特征曲线分析显示,WC 对高血压血压、血脂异常、HOMA-IR 和多种危险因素的存在提供了最佳指示(曲线下面积,.713-.763)。

结论

在这个相对年轻的 CP 成人样本中,观察到 MetS 的高患病率。WC 是比 BMI 更好的多个危险因素指标,是 CP 成人心血管代谢风险筛查的一种临床有用方法。

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