Lee Dong-Hyeon, Youn Ho-Joong, Chung Woo-Baek, Choi Yun-Seok, Lee Jong-Min, Park Chul-Soo, Jung Hae-Ok, Jeon Hui-Kyung, Lee Man-Young
Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, #505 Banpo-dong, Seocho-gu, Seoul 137-701 South Korea.
Clin Hypertens. 2017 Jan 6;23:1. doi: 10.1186/s40885-016-0057-6. eCollection 2017.
The purpose of this study was to compare the value and evaluate the validity of non-invasive methods for the detection of vascular stiffness in never-treated individuals with metabolic syndrome (MetS).
A total of 59 subjects (mean age, 60 ± 12 years; male:female = 35:24) were enrolled in the study and were categorized into the positive MetS (MetS[+]: = 32) and negative group (MetS[-]: = 27), according to the parameters set by the National Cholesterol Education Program's Adult Treatment Panel III. Pulse wave velocity (PWV) of the aorta, arm, and leg, Framingham risk score (FRS), ankle-brachial index (ABI), and carotid intima-media thickness (IMT) for vascular aging were measured for the two groups.
Aortic PWV (PWV) was significantly higher in MetS(+) than MetS(-) group (7.0 ± 1.4 m/s vs. 8.4 ± 1.6 m/s, < 0.01), while ABI was significantly lower in MetS(+) than MetS(-) group (1.2 ± 0.1 vs. 1.1 ± 0.2, = 0.03), respectively. FRS was significantly higher in MetS(+) than MetS(-) group (11 ± 5 vs. 14 ± 4, = 0.05). The both mean IMT was higher in MetS(+) than MetS(-) group (right: 0.94 ± 0.20 mm vs. 0.81 ± 0.20 mm, = 0.03; left: 0.93 ± 0.20 mm vs. 0.79 ± 0.20 mm, = 0.03, respectively). For predicting the probability of the presence of MetS, PWV was an independent tool ( = 0.04; odds ratio, 1.88; 95% confidence interval, 1.03 to 3.42) and a cut-off value of PWV of 7.4 m/s showed a sensitivity of 66.7% and a specificity of 47.6%.
We suggest that PWV, combined with traditional tools, can play an important role as a complementary or alternative tool for the detection of vascular stiffness in never-treated individuals with MetS.
本研究旨在比较未接受治疗的代谢综合征(MetS)患者中检测血管僵硬度的非侵入性方法的价值并评估其有效性。
共有59名受试者(平均年龄60±12岁;男:女 = 35:24)纳入本研究,并根据美国国家胆固醇教育计划成人治疗专家组III设定的参数分为MetS阳性组(MetS[+]:n = 32)和阴性组(MetS[-]:n = 27)。测量了两组的主动脉、手臂和腿部的脉搏波速度(PWV)、弗雷明汉风险评分(FRS)、踝臂指数(ABI)以及用于评估血管老化的颈动脉内膜中层厚度(IMT)。
MetS(+)组的主动脉PWV显著高于MetS(-)组(7.0±1.4米/秒对8.4±1.6米/秒,P<0.01),而MetS(+)组的ABI显著低于MetS(-)组(1.2±0.1对1.1±0.2,P = 0.03)。MetS(+)组的FRS显著高于MetS(-)组(11±5对14±4,P = 0.05)。MetS(+)组的双侧平均IMT均高于MetS(-)组(右侧:0.94±0.20毫米对0.81±0.20毫米,P = 0.03;左侧:0.93±0.20毫米对0.79±0.20毫米,P = 0.03)。对于预测MetS存在的概率,PWV是一个独立工具(P = 0.04;比值比,1.88;95%置信区间,1.03至3.42),PWV的截断值为7.4米/秒时,敏感性为66.7%,特异性为47.6%。
我们建议,PWV与传统工具相结合,可作为未接受治疗的MetS患者检测血管僵硬度的补充或替代工具发挥重要作用。