Wada Masaoki, Takeshima Taro, Nakamura Yosikazu, Nagasaka Shoichiro, Kamesaki Toyomi, Kajii Eiji
Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi Oki Clinic, Ibaraki Department of Public Health, Jichi Medical University, Tochigi Division of Diabetes, Metabolism and Endocrinology, Showa University Fujigaoka Hospital, Yokohama, Japan.
Medicine (Baltimore). 2016 Aug;95(31):e4510. doi: 10.1097/MD.0000000000004510.
Many chronic diseases are associated with dizziness or vertigo, as is peripheral vestibular disorder (PVD). Although carotid plaque development is linked to atherosclerosis, it is unclear whether such plaques can lead to the development of PVD. We therefore conducted this study to investigate the presence of an association between carotid plaque and new PVD events.In this retrospective study, we consecutively enrolled 393 patients ≥20 years old who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for ≥6 months at a primary care clinic (Oki Clinic, Japan) between November 2011 and March 2013. Carotid plaque presence was measured with high-resolution ultrasonography for all patients. During a 1-year follow-up period, an otorhinolaryngologist diagnosed and reported any new PVD events (the main end point). Hazard ratios (HRs) and 95% confidence intervals (CIs) for new PVD occurrence were estimated using the Cox proportional hazard regression model.The mean age of the participants was 65.5 years; 33.8% were men, and 12.7%, 82.4%, and 93.1% had diabetes mellitus, hypertension, and dyslipidemia, respectively. There were 76 new PVD events; patients with carotid plaque had a greater risk of such events (crude HR: 3.25; 95% CI: 1.62-6.52) compared to those without carotid plaque. This risk was even higher after adjusting for traditional risk factors for atherosclerosis (adjusted HR: 4.41; 95% CI: 1.75-11.14).Carotid plaques are associated with an increased risk of new PVD events.
许多慢性疾病都与头晕或眩晕有关，外周前庭疾病（PVD）也是如此。虽然颈动脉斑块的形成与动脉粥样硬化有关，但尚不清楚此类斑块是否会导致PVD的发生。因此，我们开展了这项研究，以调查颈动脉斑块与新发PVD事件之间是否存在关联。在这项回顾性研究中，我们连续纳入了393名年龄≥20岁的患者，这些患者于2011年11月至2013年3月期间在一家初级保健诊所（日本冲木诊所）接受了≥6个月的高血压、血脂异常和糖尿病等慢性疾病治疗。对所有患者均采用高分辨率超声检查测量颈动脉斑块的存在情况。在1年的随访期内，一名耳鼻喉科医生诊断并报告了任何新发PVD事件（主要终点）。使用Cox比例风险回归模型估计新发PVD发生的风险比（HR）和95%置信区间（CI）。参与者的平均年龄为65.5岁；33.8%为男性，分别有12.7%、82.4%和93.1%的患者患有糖尿病、高血压和血脂异常。有76例新发PVD事件；与无颈动脉斑块的患者相比，有颈动脉斑块的患者发生此类事件的风险更高（粗HR：3.25；95%CI：1.62 - 6.52）。在对动脉粥样硬化的传统风险因素进行校正后，这种风险更高（校正HR：4.41；95%CI：1.75 - 11.14）。颈动脉斑块与新发PVD事件风险增加有关。
