Kim Hack-Lyoung, Kim Myung-A, Oh Sohee, Kim Mina, Park Seong Mi, Yoon Hyun Ju, Shin Mi Seung, Hong Kyung-Soon, Shin Gil Ja, Shim Wan-Joo
1 Seoul National University Boramae Medical Center , Seoul, Korea.
2 Korea University Anam Hospital , Seoul, Korea.
Metab Syndr Relat Disord. 2016 Dec;14(10):507-512. doi: 10.1089/met.2016.0078. Epub 2016 Oct 6.
Sex-related differences in the influence of metabolic syndrome (MetS) on various cardiovascular diseases have been suggested. The aim of this study was to investigate the effect of sex on the association between MetS and left ventricular (LV) diastolic dysfunction in patients with suspected coronary artery disease (CAD).
Two hundred ten patients (105 men and age-matched 105 women; mean age: 56.5 ± 10.9 years) undergoing elective coronary angiography for the evaluation of CAD were studied. MetS was defined according to the International Diabetes Federation criteria. LV diastolic function was assessed using transthoracic echocardiography.
The incidence of MetS was 23.8% in men and 14.3% in women (P = 0.079). The incidence of LV diastolic dysfunction was significantly different by MetS in women, but not in men. In multiple linear regression analyses, the number of MetS components was independently associated with septal e' velocity, E/e', and left atrial (LA) diameter in women (P < 0.05 for each). In men, the number of MetS components was associated with only LA size in this analysis. As the number of components of MetS increased, septal e' velocity decreased proportionally in women (P < 0.001), but not in men (P = 0.117).
Among middle-aged and elderly Korean patients at high risk of CAD, the impact of MetS on LV diastolic dysfunction was more pronounced in women than in men. This suggests the important role of sex hormonal effects in the development of LV diastolic dysfunction in relation to MetS in this population.
有研究表明代谢综合征（MetS）对各种心血管疾病的影响存在性别差异。本研究旨在探讨性别对疑似冠心病（CAD）患者中MetS与左心室（LV）舒张功能障碍之间关联的影响。
对210例因评估CAD而接受选择性冠状动脉造影的患者（105例男性和年龄匹配的105例女性；平均年龄：56.5±10.9岁）进行了研究。根据国际糖尿病联盟标准定义MetS。使用经胸超声心动图评估LV舒张功能。
男性MetS的发生率为23.8%，女性为14.3%（P = 0.079）。女性中，MetS导致的LV舒张功能障碍发生率有显著差异，而男性则无。在多元线性回归分析中，MetS组分数量与女性的室间隔e'速度、E/e'和左心房（LA）直径独立相关（每项P < 0.05）。在此分析中，男性的MetS组分数量仅与LA大小相关。随着MetS组分数量增加，女性的室间隔e'速度成比例下降（P < 0.001），而男性则无（P = 0.117）。
在有CAD高风险的韩国中老年患者中，MetS对LV舒张功能障碍的影响在女性中比在男性中更明显。这表明在该人群中，性激素效应在与MetS相关的LV舒张功能障碍发展中起重要作用。
