Kubozono Takuro, Miyata Masaaki, Kawasoe Shin, Ojima Satoko, Yoshifuku Shiro, Miyahara Hironori, Maenohara Shigeho, Ohishi Mitsuru
Department of Cardiovascular Medicine and Hypertension, Kagoshima University.
Circ J. 2017 Feb 24;81(3):310-315. doi: 10.1253/circj.CJ-16-0687. Epub 2016 Dec 29.
Although there have been several reports on the risk factors associated with intima-media thickness (IMT), many questions remain. The purpose of this study was to investigate the association between IMT and cardiovascular risk factors in a Japanese general population.
The study group consisted of 1,583 male subjects undergoing routine health checkups. IMT of the common carotid artery was measured by high-resolution ultrasonography. Brachial-ankle pulse wave velocity (baPWV) was measured using an automated device. Univariate analysis demonstrated that carotid IMT significantly associated with age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), baPWV, fasting glucose, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Multiple logistic regression analysis for carotid atherosclerosis (carotid IMT ≥1.0 mm) was performed using obesity (BMI ≥25.0 kg/m), high BP (SBP ≥130 mmHg or DBP ≥85 mmHg), dyslipidemia (LDL-C ≥140 mg/dL, TG ≥150 mg/dL, or HDL-C <40 mg/dL), impaired fasting glucose (IFG) (fasting glucose ≥110 g/dL), and high baPWV (≥1,400 cm/s). Carotid atherosclerosis was significantly associated with only high baPWV (OR: 2.22, 95% CI: 1.24-4.17, P<0.01).
High baPWV was a stronger predictor of early carotid atherosclerosis than high BP, dyslipidemia, or IFG in a Japanese general male population.
尽管已有多篇关于内膜中层厚度(IMT)相关危险因素的报道,但仍存在许多问题。本研究旨在调查日本普通人群中IMT与心血管危险因素之间的关联。
研究组由1583名接受常规健康检查的男性受试者组成。通过高分辨率超声测量颈总动脉的IMT。使用自动装置测量臂踝脉搏波速度(baPWV)。单因素分析表明,颈动脉IMT与年龄、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、baPWV、空腹血糖、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)显著相关。对颈动脉粥样硬化(颈动脉IMT≥1.0 mm)进行多因素逻辑回归分析,使用肥胖(BMI≥25.0 kg/m)、高血压(SBP≥130 mmHg或DBP≥85 mmHg)、血脂异常(LDL-C≥140 mg/dL、TG≥150 mg/dL或HDL-C<40 mg/dL)、空腹血糖受损(IFG)(空腹血糖≥110 mg/dL)和高baPWV(≥1400 cm/s)。颈动脉粥样硬化仅与高baPWV显著相关(比值比:2.22,95%置信区间:1.24 - 4.17,P<0.01)。
在日本普通男性人群中,高baPWV比高血压、血脂异常或IFG更能预测早期颈动脉粥样硬化。