Vaverková H, Karásek D, Novotný D, Halenka M, Orság J, Slavík L
Third Department of Internal Medicine - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic.
Physiol Res. 2015;64(Suppl 3):S385-94. doi: 10.33549/physiolres.933198.
With the increasing prevalence of obesity and especially abdominal obesity, a simple clinical tool is needed that identifies the cardiometabolic risk for cardiovascular disease and type 2 diabetes. The aim of our study was to evaluate a broad spectrum of metabolic variables and IMT in subjects with and without hypertriglyceridemic waist (HTGW) and compare it with the harmonized definition of metabolic syndrome (MS) with both a higher (MS-I) and lower waist circumference (MS-II) for Europids. We enrolled 607 asymptomatic dyslipidemic subjects (295 men and 312 women) into our cross-sectional study. The subjects with HTGW had an atherogenic lipid profile (significantly higher triglycerides, AIP, non-HDL-C, lower HDL-C and ApoA-1, and the women also higher TC and ApoB), increased markers of insulin resistance (insulin, HOMA, C-peptide, proinsulin), inflammation (hsCRP), thrombosis (fibrinogen, PAI-1), SBP and DBP, and lower adiponectin (p<0.05-0.001 for all). These risk factors were entirely similar in HTGW, MS-I and MS-II. Age-adjusted IMT was significantly higher only in the women with HTGW but this significance disappeared after further adjustment for TC, SBP, and smoking. Our results support the routine use of HTGW as a simple and inexpensive screening tool to detect subjects at increased cardiometabolic risk in clinical practice.
随着肥胖尤其是腹型肥胖患病率的不断上升,需要一种简单的临床工具来识别心血管疾病和2型糖尿病的心脏代谢风险。我们研究的目的是评估有和没有高甘油三酯血症腰围(HTGW)的受试者的一系列代谢变量和内膜中层厚度(IMT),并将其与欧洲裔人群中较高腰围(MS-I)和较低腰围(MS-II)的代谢综合征(MS)统一定义进行比较。我们将607名无症状血脂异常受试者(295名男性和312名女性)纳入我们的横断面研究。HTGW受试者具有致动脉粥样硬化的血脂谱(甘油三酯、动脉粥样硬化指数、非高密度脂蛋白胆固醇显著升高,高密度脂蛋白胆固醇和载脂蛋白A-1降低,女性的总胆固醇和载脂蛋白B也升高)、胰岛素抵抗标志物(胰岛素、稳态模型评估胰岛素抵抗、C肽、胰岛素原)、炎症(高敏C反应蛋白)、血栓形成(纤维蛋白原、纤溶酶原激活物抑制剂-1)、收缩压和舒张压升高,脂联素降低(所有p<0.05-0.001)。这些危险因素在HTGW、MS-I和MS-II中完全相似。年龄调整后的IMT仅在HTGW女性中显著升高,但在进一步调整总胆固醇、收缩压和吸烟后,这种显著性消失。我们的结果支持在临床实践中常规使用HTGW作为一种简单且廉价的筛查工具,以检测心脏代谢风险增加的受试者。