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肺动脉高压患者中代谢综合征的患病率。

Prevalence of metabolic syndrome in patients with pulmonary hypertension.

作者信息

Ussavarungsi Kamonpun, Thomas Colleen S, Burger Charles D

机构信息

Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA.

Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA.

出版信息

Clin Respir J. 2017 Nov;11(6):721-726. doi: 10.1111/crj.12406. Epub 2015 Nov 9.

Abstract

BACKGROUND AND AIMS

To determine the prevalence of metabolic syndrome (MetS) - a potential phenotypical risk for pulmonary hypertension (PH) - in patients with PH and by PH diagnostic group including group 1 pulmonary arterial hypertension (PAH); group 1.1 idiopathic PAH, groups 1.2 heritable PAH, 1.3 drug and toxin induced, 1.4 associated PAH, group 2 PH with left heart disease, group 3 PH associated with lung disease and/or hypoxemia, group 4 PH owing to chronic thrombotic and/or embolic disease, and group 5 PH from multifactorial mechanisms.

METHODS

We conducted a retrospective chart review of patients referred to Mayo Clinic in Florida from January 1990 to October 2013 (N = 1287). Only patients whom PH was confirmed by right heart catheterization were included (N = 640). MetS was defined with at least three of the following: systemic hypertension, diabetes mellitus, hyperlipidemia and body mass index > 30.

RESULTS

MetS was prevalent in 247 of 640 (39%) with PH: 13% in group 1.1 PAH, 12% in groups 1.2-1.4 PAH, 54% in group 2, 55% in group 3, 23% in group 4 and 24% in group 5. After adjusting for age, sex and race, diagnostic subgroup analysis revealed a higher prevalence of MetS in WHO Group 2 PH patients [adjusted odd ratios (OR): 2.58, P < 0.0001] and WHO group 3 PH (adjusted OR: 2.77, P < 0.0001) when compared to group 1 PH.

CONCLUSION

The prevalence of MetS was observed in 39% of patients with PH; however, among PH patients, the prevalence was higher in group 2 and 3 PH.

摘要

背景与目的

确定代谢综合征(MetS)——肺动脉高压(PH)的一种潜在表型风险——在PH患者中的患病率,并按PH诊断分组进行分析,包括1组肺动脉高压(PAH);1.1组特发性PAH,1.2组遗传性PAH,1.3组药物和毒素诱导的PAH,1.4组相关性PAH,2组左心疾病所致的PH,3组与肺部疾病和/或低氧血症相关的PH,4组慢性血栓栓塞性疾病所致的PH,以及5组多因素机制所致的PH。

方法

我们对1990年1月至2013年10月转诊至佛罗里达州梅奥诊所的患者进行了回顾性病历审查(N = 1287)。仅纳入经右心导管检查确诊为PH的患者(N = 640)。MetS定义为具备以下至少三项:系统性高血压、糖尿病、高脂血症和体重指数>30。

结果

640例PH患者中有247例(39%)存在MetS:1.1组PAH中为13%,1.2 - 1.4组PAH中为12%,2组中为54%,3组中为55%,4组中为23%,5组中为24%。在调整年龄、性别和种族后,诊断亚组分析显示,与1组PH相比,世界卫生组织(WHO)2组PH患者中MetS的患病率更高[调整后的比值比(OR):2.58, P < 0.0001],WHO 3组PH患者中MetS的患病率也更高(调整后的OR:2.77, P < 0.0001)。

结论

在39%的PH患者中观察到MetS的患病率;然而,在PH患者中,2组和3组PH的患病率更高。

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