Zeng Qiang, Dong Sheng-Yong, Wang Man-Liu, Li Jin-Ming, Ren Chong-Lei, Gao Chang-Qing
Health Management Institute, Chinese PLA General Hospital, Beijing 100853, China.
Healthcare Department, Agency for Offices Administration of PLA, Beijing 100034, China.
Prev Med. 2016 Oct;91:62-69. doi: 10.1016/j.ypmed.2016.08.001. Epub 2016 Aug 3.
To investigate associations of novel cardiovascular markers with obesity in a general population.
A total of 9361 individuals without diabetes or cardiovascular disease were studied between 2009 and 2012 in China. High-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), brachial-ankle pulse wave velocity (baPWV), pulse pressure, and central systolic blood pressure (cSBP) were assessed according to body mass index (BMI) levels and different BMI/metabolic syndrome (MetS) combinations.
'Levels of hs-cTnT, baPWV, pulse pressure, and cSBP increased across BMI levels. Obesity was positively associated with these markers in multivariate models (P<0.05 for all). When stratified by MetS, these associations remained significant in the non-MetS group, and compared with normal weight participants, the obese participants had 1.87 (95% confidence interval: 1.48, 2.36), 1.27 (1.02, 1.57), 1.89 (1.39, 2.57), and 2.71 (2.11, 3.47) fold risks for having elevated hs-cTnT, baPWV, pulse pressure, and cSBP, respectively, and had 1.61 (1.26, 2.05), 1.75 (1.27, 2.42), 2.45 (1.46, 4.11), and 3.14 (2.13, 4.62) fold risks for having 1, 2, 3, and 4 elevated cardiovascular markers, respectively; while no relationship was observed between obesity and these novel markers in the MetS group, after multivariate adjustment. These results were unchanged when using a waist-hip ratio, body fat per cent, and visceral adiposity index to redefine obesity.
Obesity was positively associated with novel cardiovascular markers (except NT-proBNP) in participants without MetS rather than in participants with MetS. Obese participants without MetS also had higher odds of having more number of elevated cardiovascular markers.
在普通人群中研究新型心血管标志物与肥胖之间的关联。
2009年至2012年期间，在中国对9361名无糖尿病或心血管疾病的个体进行了研究。根据体重指数（BMI）水平和不同的BMI/代谢综合征（MetS）组合，评估了高敏心肌肌钙蛋白T（hs-cTnT）、N末端B型利钠肽原（NT-proBNP）、臂踝脉搏波速度（baPWV）、脉压和中心收缩压（cSBP）。
hs-cTnT、baPWV、脉压和cSBP水平随BMI水平升高而升高。在多变量模型中肥胖与这些标志物呈正相关（所有P<0.05）。按MetS分层时，这些关联在非MetS组中仍然显著，与正常体重参与者相比，肥胖参与者hs-cTnT、baPWV、脉压和cSBP升高的风险分别为1.87倍（95%置信区间：1.48，2.36）、1.27倍（1.02，1.57）、1.89倍（1.39，2.57）和2.71倍（2.11，3.47），并且有1、2、3和4种心血管标志物升高的风险分别为1.61倍（1.26，2.05）、1.75倍（1.27，2.42）、2.45倍（1.46，4.11）和3.14倍（2.13，4.62）；而在多变量调整后，MetS组中未观察到肥胖与这些新型标志物之间的关系。当使用腰臀比、体脂百分比和内脏脂肪指数重新定义肥胖时，这些结果不变。
在无MetS的参与者中，肥胖与新型心血管标志物（NT-proBNP除外）呈正相关，而在有MetS的参与者中并非如此。无MetS的肥胖参与者出现更多心血管标志物升高的几率也更高。
