Maddaloni Ernesto, Cavallari Ilaria, De Pascalis Mariangela, Keenan Hillary, Park Kyoungmin, Manfrini Silvia, Buzzetti Raffaella, Patti Giuseppe, Di Sciascio Germano, Pozzilli Paolo
Unit of Endocrinology and Diabetes, Department of Medicine, University Campus Bio-Medico, Rome, Italy; Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts.
Department of Cardiovascular Sciences, University Campus Bio-Medico, Rome, Italy.
Am J Cardiol. 2016 Sep 15;118(6):822-827. doi: 10.1016/j.amjcard.2016.06.044. Epub 2016 Jun 28.
Body circumferences have been proposed as potential anthropometric measures for the assessment of cardiometabolic risk as they are independently associated with insulin resistance and diabetes. The aim of this study was to validate neck and wrist circumference and waist-to-hip ratio as practical markers of metabolic dysfunction and atherosclerosis; 120 subjects who underwent coronary angiography and carotid Doppler ultrasound were enrolled in this cross-sectional study. Exclusion criteria were history of diabetes, acute myocardial infarction, body mass index (BMI) <18.5 or ≥45.0 kg/m(2). Metabolic dysfunction was ascertained by the calculation of visceral adiposity index (VAI) and by diagnosis of metabolic syndrome (MS). Advanced atherosclerotic disease was defined as ≥70% coronary lumen and/or ≥50% carotid lumen stenosis. No association between body circumferences and VAI or MS was found in subjects with BMI <25 kg/m(2). VAI was significantly related to waist-to-hip ratio (R(2) = 0.09, p = 0.008), neck (R(2) = 0.09, p = 0.007), and wrist circumferences (R(2) = 0.05, p = 0.041) in subjects with BMI ≥25 kg/m(2). In overweight subjects, higher gender-specific tertiles of wrist circumference were independently associated with an increased risk of MS (odds ratio 2.57, 95% confidence interval 1.11 to 5.96, p = 0.028). VAI was independently associated with carotid intima-media thickness: β = 0.104, R(2) = 0.118, p = 0.003. Carotid intima-media thickness and MS, but not body circumferences, were associated with advanced atherosclerosis. In conclusion, these data indicate that anthropometric measurements, in particular wrist circumference, can be used as practical tools for assessment of metabolic risk in overweight-obese subjects but not as markers of advanced atherosclerosis.
身体周长已被提议作为评估心血管代谢风险的潜在人体测量指标，因为它们与胰岛素抵抗和糖尿病独立相关。本研究的目的是验证颈围、腕围和腰臀比作为代谢功能障碍和动脉粥样硬化的实用标志物；120名接受冠状动脉造影和颈动脉多普勒超声检查的受试者参与了这项横断面研究。排除标准为糖尿病史、急性心肌梗死、体重指数（BMI）<18.5或≥45.0kg/m²。通过计算内脏脂肪指数（VAI）和诊断代谢综合征（MS）来确定代谢功能障碍。晚期动脉粥样硬化疾病定义为冠状动脉管腔狭窄≥70%和/或颈动脉管腔狭窄≥50%。在BMI<25kg/m²的受试者中，未发现身体周长与VAI或MS之间存在关联。在BMI≥25kg/m²的受试者中，VAI与腰臀比（R² = 0.09，p = 0.008）、颈围（R² = 0.09，p = 0.007）和腕围（R² = 0.05，p = 0.041）显著相关。在超重受试者中，较高的性别特异性腕围三分位数与MS风险增加独立相关（比值比2.57，95%置信区间1.11至5.96，p = 0.028）。VAI与颈动脉内膜中层厚度独立相关：β = 0.104，R² = 0.118，p = 0.003。颈动脉内膜中层厚度和MS与晚期动脉粥样硬化相关，但身体周长与晚期动脉粥样硬化无关。总之，这些数据表明，人体测量指标，特别是腕围，可作为评估超重肥胖受试者代谢风险的实用工具，但不能作为晚期动脉粥样硬化的标志物。
