Qin Guangming, Chen Zhihao, Su Weiwei, Geng Xiaoge, Chen Xiaojun, Xu Xiang, Pan Wensheng
Department of Laboratory Department of Gastroenterology Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Medicine (Baltimore). 2017 Mar;96(11):e6237. doi: 10.1097/MD.0000000000006237.
Interventions of cardiovascular disease should be implemented in early ages. But most studies were performed in middle aged or elderly adults because of the low prevalence in young, especially for women. We investigate the association between metabolic risk factors and subclinical atherosclerosis in young asymptomatic women adults, using carotid intima-media thickness (CIMT) as a marker of the atherosclerotic process.We performed a cross-sectional study of 950 Chinese young asymptomatic women adults (37.28 ± 5.16 years) who underwent a routine health screening examination. Triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), fasting blood glucose (FBG), homocysteine (HCY), gamma glutamyltransferase (GGT), uric acid, and CIMT were measured.Out of 950 subjects, 16 (1.7%) were detected with increased CIMT. Significant differences existed in the indicators including age, body mass index (BMI), TC, TG, LDL-C, LDL-C/HDL-C, non-HDL-C, and TC/HDL-C. Although TG, LDL-C, non-HDL-C, TC/HDL-C, and TG/HDL-C were the significant indicators when adjusted for age only, age, LDL-C/HDL-C, FBG, and GGT were the only independent relative indicators of increased CMIT that entered the multivariate model. The area under receiver operating characteristic curve for a linear combination of age, LDL-C/HDL-C, FBG, and GGT was 0.809 (95% confidence interval = 0.712-0.906), superior to any of the variables taken alone (age, AUC = 0.707; FBG, AUC = 0.710; LDL-C/HDL-C, AUC = 0.695; GGT, AUC = 0.648).The combined assessment of age, LDL-C/HDL-C, FBG, and GGT contributes to an early detection for subclinical atherosclerosis, providing guidance to clinicians for women's early interventions of latent cardiovascular disease. Neither of the above four individual indicators is qualified alone.
心血管疾病的干预措施应在早期实施。但由于年轻人中患病率较低，尤其是女性，大多数研究是在中年或老年成年人中进行的。我们以颈动脉内膜中层厚度（CIMT）作为动脉粥样硬化进程的标志物，研究年轻无症状成年女性代谢危险因素与亚临床动脉粥样硬化之间的关联。我们对950名接受常规健康筛查的中国年轻无症状成年女性（37.28±5.16岁）进行了横断面研究。测量了甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、空腹血糖（FBG）、同型半胱氨酸（HCY）、γ-谷氨酰转移酶（GGT）、尿酸和CIMT。在950名受试者中，16名（1.7%）被检测出CIMT增加。在年龄、体重指数（BMI）、TC、TG、LDL-C、LDL-C/HDL-C、非HDL-C和TC/HDL-C等指标上存在显著差异。虽然仅调整年龄时TG、LDL-C、非HDL-C、TC/HDL-C和TG/HDL-C是显著指标，但年龄、LDL-C/HDL-C、FBG和GGT是进入多变量模型的仅有的CMIT增加的独立相关指标。年龄、LDL-C/HDL-C、FBG和GGT线性组合的受试者工作特征曲线下面积为0.809（95%置信区间=0.712-0.906），优于任何单独的变量（年龄，AUC=0.707；FBG，AUC=0.710；LDL-C/HDL-C，AUC=0.695；GGT，AUC=0.648）。年龄、LDL-C/HDL-C、FBG和GGT的联合评估有助于亚临床动脉粥样硬化的早期检测，为临床医生对女性潜在心血管疾病的早期干预提供指导。上述四个单独指标中没有一个单独符合要求。
