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慢性阻塞性肺疾病患者代谢综合征与心外膜脂肪组织厚度的关系

Relationship between metabolic syndrome and epicardial fat tissue thickness in patients with chronic obstructive pulmonary disease.

作者信息

Demir Melike, Acet Halit, Kaya Halide, Taylan Mahsuk, Yüksel Murat, Yılmaz Süreyya, Sezgi Cengizhan, Karadeniz Gülistan, Yenibertiz Derya

机构信息

Department of Chest Disease, Faculty of Medicine, Dicle University, Diyarbakır-Turkey.

Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır-Turkey.

出版信息

Anatol J Cardiol. 2016 Jun;16(6):405-411. doi: 10.14744/AnatolJCardiol.2016.6566. Epub 2016 Feb 10.

Abstract

OBJECTIVE

An increase in epicardial fat tissue (EFT) thickness was found to be associated with metabolic syndrome (MS) and ischemic heart disease. MS is a comorbidity of chronic obstructive pulmonary disease (COPD) resulting from the accompanying systemic inflammation. The aim of our study was to investigate the usefulness of EFT thickness to predict MS in COPD patients.

METHODS

COPD patients admitted to our clinic during January-December 2014 and healthy controls were included in this prospective case control study. Patients with comorbidities, COPD exacerbation, and malignancies were excluded. Patients and controls were compared in terms of anthropometric measurements, MS-related examination and laboratory findings, pulmonary function tests, and EFT thickness. The correlations between EFT thickness and markers of MS in COPD were evaluated using the Student's t-test and logistic regression analysis.

RESULTS

COPD patients and controls were composed of 82 and 84 individuals, respectively. MS was diagnosed in 31 (37.8%) COPD patients. The EFT thickness was significantly higher in COPD patients than in the controls and was also higher in COPD patients with MS than in those without MS (all p<0.001). Each 1-mm increment of EFT raised the risk of MS two-fold (p=0.011, OR=2.08, 95% CI: 1.18-3.68). Increase in triglyceride level (p=0.004, OR=1.02, 95% CI: 1.01-1.03) and reduction in forced vital capacity (p=0.025, OR=0.26, 95% CI: 0.08-0.84) were found to be associated with increased MS risk. The cut-off value for EFT thickness in the prediction of MS in COPD patients was 6.75 mm (sensitivity: 83%, specificity: 65%).

CONCLUSION

EFT thickness is a non-invasive and easily available parameter, which is valuable in the prediction of increased MS risk in COPD patients. Early diagnosis of patients at risk of MS may help to prevent ischemic heart disease in these patients.

摘要

目的

已发现心外膜脂肪组织(EFT)厚度增加与代谢综合征(MS)及缺血性心脏病相关。MS是由伴随的全身炎症导致的慢性阻塞性肺疾病(COPD)的一种合并症。我们研究的目的是探讨EFT厚度对预测COPD患者MS的有用性。

方法

本前瞻性病例对照研究纳入了2014年1月至12月期间入住我们诊所的COPD患者及健康对照。排除患有合并症、COPD急性加重及恶性肿瘤的患者。对患者和对照进行人体测量、与MS相关的检查及实验室检查结果、肺功能测试和EFT厚度方面的比较。使用学生t检验和逻辑回归分析评估COPD患者中EFT厚度与MS标志物之间的相关性。

结果

COPD患者和对照分别由82例和84例个体组成。31例(37.8%)COPD患者被诊断为MS。COPD患者的EFT厚度显著高于对照,且患有MS的COPD患者的EFT厚度也高于未患MS的患者(所有p<0.001)。EFT每增加1毫米,MS风险增加两倍(p=0.011,OR=2.08,95%CI:1.18 - 3.68)。发现甘油三酯水平升高(p=0.004,OR=1.02,95%CI:1.01 - 1.03)和用力肺活量降低(p=0.025,OR=0.26,95%CI:0.08 - 0.84)与MS风险增加相关。COPD患者中预测MS的EFT厚度临界值为6.75毫米(敏感性:83%,特异性:65%)。

结论

EFT厚度是一个非侵入性且易于获得的参数,对预测COPD患者MS风险增加具有重要价值。对有MS风险的患者进行早期诊断可能有助于预防这些患者发生缺血性心脏病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1908/5331372/fa10738ef36b/AJC-16-405-g001.jpg

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