中年男性代谢状态长期变化对心血管生物标志物和微血管内皮功能的影响：一项25年的前瞻性研究。
The impact of long-term changes in metabolic status on cardiovascular biomarkers and microvascular endothelial function in middle-aged men: a 25-year prospective study.
作者信息
Kwaśniewska Magdalena, Kozińska Joanna, Dziankowska-Zaborszczyk Elżbieta, Kostka Tomasz, Jegier Anna, Rębowska Ewa, Orczykowska Milena, Leszczyńska Joanna, Drygas Wojciech
机构信息
Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland.
Department of Epidemiology and Biostatistics, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland.
出版信息
Diabetol Metab Syndr. 2015 Sep 17;7:81. doi: 10.1186/s13098-015-0074-8. eCollection 2015.
BACKGROUND
The aim of this analysis was to examine long-term effects of changes in metabolic status on microvascular endothelial function and cardiovascular diseases (CVD) biomarkers among physically active middle-aged men.
METHODS
Metabolically healthy men (n = 101, mean age 59.7 years), free of symptoms and treatment, have been prospectively observed for their lifestyle and CVD risk factors (observation period 24.7 years). At the latest follow-up (2011/2012) a set of CVD biomarkers was measured using enzyme-linked immunosorbent assay. Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. At follow-up the participants were divided into metabolically healthy (0-1 metabolic parameters) and metabolically unhealthy (≥2 metabolic parameters) groups. Metabolic syndrome was defined according to the NCEP ATP III definition.
RESULTS
Traditional metabolic risk factors were significantly associated with hsCRP, ox-LDL, Il-6, leptin and adiponectin/leptin ratio. Reactive hyperemia index was negatively related to body mass (p < 0.01), waist circumference (p < 0.05), triglycerides (p < 0.01), TG/HDL ratio (p < 0.01), uric acid (p < 0.05), sICAM-1 (p < 0.05) and Il-6 (p < 0.05), and positively to HDL-C (p < 0.01) and leisure-time physical activity (p < 0.01). Men who maintained metabolically healthy status (n = 47) through the observation had significantly lower hsCRP and uric acid (p < 0.05), higher adiponectin/leptin ratio (p < 0.05), higher mean RHI and lower prevalence of endothelial dysfunction (p < 0.05) as compared to the metabolically unhealthy group (n = 54). Regular physical activity level was significantly higher among metabolically healthy individuals during the whole observation.
CONCLUSIONS
Even subtle changes in metabolic profile influence inflammatory biomarkers and microvascular endothelial function. Leptin, adiponectin/leptin ratio and hsCRP are significant predictors of metabolic profile. Interleukine-6 and sICAM-1 may be used as indicators of early endothelial dysfunction in asymptomatic men. High leisure-time physical activity level is an important contributor of metabolically healthy profile through middle adulthood.
背景
本分析的目的是研究代谢状态变化对身体活跃的中年男性微血管内皮功能和心血管疾病（CVD）生物标志物的长期影响。
方法
对101名代谢健康的男性（平均年龄59.7岁）进行前瞻性观察，这些男性无症状且未接受治疗，观察其生活方式和CVD危险因素（观察期24.7年）。在最近一次随访（2011/2012年）时，使用酶联免疫吸附测定法测量一组CVD生物标志物。使用Endo-PAT2000系统通过反应性充血指数（RHI）评估微血管内皮功能。在随访时，将参与者分为代谢健康（0 - 1个代谢参数）和代谢不健康（≥2个代谢参数）组。代谢综合征根据NCEP ATP III定义进行定义。
结果
传统代谢危险因素与hsCRP、氧化型低密度脂蛋白（ox-LDL）、白细胞介素-6（Il-6）、瘦素和脂联素/瘦素比值显著相关。反应性充血指数与体重（p < 0.01）、腰围（p < 0.05）、甘油三酯（p < 0.01）、甘油三酯/高密度脂蛋白（TG/HDL）比值（p < 0.01）、尿酸（p < 0.05）、可溶性细胞间黏附分子-1（sICAM-1）（p < 0.05）和Il-6（p < 0.05）呈负相关，与高密度脂蛋白胆固醇（HDL-C）（p < 0.01）和休闲时间身体活动（p < 0.01）呈正相关。在整个观察期内，保持代谢健康状态的男性（n =47）与代谢不健康组（n =54）相比，hsCRP和尿酸显著更低（p < 0.05），脂联素/瘦素比值更高（p < 0.05），平均RHI更高，内皮功能障碍患病率更低（p < 0.05）。在整个观察期内，代谢健康个体的规律身体活动水平显著更高。
结论
即使代谢状况的细微变化也会影响炎症生物标志物和微血管内皮功能。瘦素、脂联素/瘦素比值和hsCRP是代谢状况的重要预测指标。白细胞介素-6和sICAM-1可作为无症状男性早期内皮功能障碍的指标。高休闲时间身体活动水平是中年期代谢健康状况的重要促成因素。
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