代谢综合征、同型半胱氨酸和B族维生素对高血压患者颈动脉内膜中层厚度的影响
The Impact of Metabolic Syndrome, Homocysteine, and B Vitamins on Carotid Artery Intima-Media Thickness in Hypertensive Patients.
作者信息
Liu Chung-Pin, Lin Yu-Li, Lin Yen-Hung, Pao Kuan-Yin, Wu Vin-Cent, Su Ta-Chen, Hung Chi-Sheng, Gau Churn-Shiouh, Hwang Juey-Jen
机构信息
Department of Internal Medicine, Yuan's General Hospital, Kaohsiung, Taiwan;
Department of Business Administration, Chihlee Institute of Technology, New Taipei City, Taiwan;
出版信息
Acta Cardiol Sin. 2013 Jan;29(1):56-63.
OBJECTIVES
To examine the correlation between metabolic syndrome (MS), plasma total homocysteine (tHcy) level, and serum B vitamin levels on carotid intima-media thickness (CIMT) in hypertensive patients.
METHODS
A total of 73 medically treated hypertensive patients (42 men, mean age 70.7 years), fasted for 10 hours, and provided fasting blood samples for measurement of plasma tHcy, serum folic acid, and serum vitamin B12 levels. Additionally, B-mode ultrasound of the distal right common carotid arteries was performed on all participants.
RESULTS
There were 50 patients with and 23 patients without MS. Patients with MS had larger CIMT than patient without (0.81 ± 0.13 vs. 0.74 ± 0.10 mm, p = 0.018). Patients with MS had larger waist circumference (p < 0.001), higher body mass index (p < 0.001), elevated serum triglyceride level (p < 0.001), lower serum high density lipoprotein level (p = 0.016), higher prevalence of diabetes mellitus (p = 0.012), higher prevalence of hyperlipidemia (p = 0.019), and a higher prevalence of fibrate usage (p = 0.025) than patients without MS. In univariate analysis, CIMT correlated significantly with the presence of MS (r = 0.256; p = 0.029), usage of angiotensin receptor blocker (ARB; r = -0.256; p = 0.029), and male gender (r = 0.247; p = 0.035). The relationships between CIMT and serum folic acid level (r = -0.212; p = 0.072) or statin usage (r = 0.207; p = 0.079) were borderline significant. In multivariate regression analysis, after adjusting for age and gender, only usage of ARB (β value -0.078, 95% CI: -0.140 to -0.015, p = 0.016) and the presence of MS (β value 0.075, 95% CI: 0.020 to 0.131, p = 0.009) were associated with CIMT. In anothermodel, after adjusting four additional parameters including age, gender, systolic blood pressure and usage of statin, usage of ARB (β value -0.074, 95% CI: -0.137 to -0.011, p = 0.022) and presence of MS (β value 0.069, 95% CI: 0.012 to 0.125, p = 0.017) remained significantly correlated with CIMT.
CONCLUSION
MS and usage of ARB are associated with CIMT in hypertensive patients.
KEY WORDS
Folic acid; Homocysteine, Intima-media thickness, Metabolic syndrome.
目的
研究高血压患者代谢综合征（MS）、血浆总同型半胱氨酸（tHcy）水平、血清B族维生素水平与颈动脉内膜中层厚度（CIMT）之间的相关性。
方法
共纳入73例接受药物治疗的高血压患者（42例男性，平均年龄70.7岁），禁食10小时后采集空腹血样，检测血浆tHcy、血清叶酸和血清维生素B12水平。此外，对所有参与者进行右侧颈总动脉远端的B超检查。
结果
50例患者患有MS，23例患者未患MS。患有MS的患者CIMT大于未患MS的患者（0.81±0.13 vs. 0.74±0.10mm，p = 0.018）。患有MS的患者腰围更大（p < 0.001）、体重指数更高（p < 0.001）、血清甘油三酯水平升高（p < 0.001）、血清高密度脂蛋白水平更低（p = 0.016）、糖尿病患病率更高（p = 0.012）、高脂血症患病率更高（p = 0.019）、贝特类药物使用比例更高（p = 0.025）。单因素分析中，CIMT与MS的存在（r = 0.256；p = 0.029）、血管紧张素受体阻滞剂（ARB）的使用（r = -0.256；p = 0.029）和男性性别（r = 0.247；p = 0.035）显著相关。CIMT与血清叶酸水平（r = -0.212；p = 0.072）或他汀类药物使用（r = 0.207；p = 0.079）之间的关系接近显著。多因素回归分析中，校正年龄和性别后，仅ARB的使用（β值-0.078，95%CI：-0.140至-0.015，p = 0.016）和MS的存在（β值0.075，95%CI：0.020至0.131，p = 0.009）与CIMT相关。在另一个模型中，校正年龄、性别、收缩压和他汀类药物使用等另外四个参数后，ARB的使用（β值-0.074，95%CI：-0.137至-0.011，p = 0.022）和MS的存在（β值0.069，95%CI：0.012至0.125，p = 0.017）仍与CIMT显著相关。
结论
MS和ARB的使用与高血压患者的CIMT相关。
关键词
叶酸；同型半胱氨酸；内膜中层厚度；代谢综合征
Zotero 插件