心力衰竭患者中腰围增大合并甘油三酯升高（高甘油三酯血症腰围表型）及高密度脂蛋白胆固醇情况。
Enlarged waist combined with elevated triglycerides (hypertriglyceridemic waist phenotype) and HDL-cholesterol in patients with heart failure.
作者信息
Weschenfelder Camila, Marcadenti Aline, Stein Airton Tetelbom, Gottschall Catarina Bertaso Andreatta
机构信息
Nutritionist, Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre (RS), Brazil.
PhD. Professor, Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), and Adjunct Professor, Department of Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre (RS), Brazil.
出版信息
Sao Paulo Med J. 2017 Jan-Feb;135(1):50-56. doi: 10.1590/1516-3180.2016.004519102016.
CONTEXT AND OBJECTIVE
: The association of serum triglycerides plus waist circumference seems to be a good marker of cardiovascular risk and has been named the "hypertriglyceridemic waist" phenotype. The aim of our study was to investigate the association between the hypertriglyceridemic waist phenotype and HDL-cholesterol among patients with heart failure.
DESIGN AND SETTING
: Cross-sectional study in a tertiary-level hospital in southern Brazil.
METHODS
: We included patients with heart failure aged > 40 years. Anthropometric assessment (weight, height, waist and hip circumferences) was performed; body mass index (BMI) and waist-hip ratio were calculated and lipid measurements (serum total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides) were collected. In men and women, respectively, waist circumference ≥ 94 cm and ≥ 80 cm, and triglycerides ≥ 150 mg/dl were considered abnormal and were used to identify the hypertriglyceridemic waist phenotype. Analyses of covariance were used to evaluate possible associations between levels of HDL-cholesterol and the hypertriglyceridemic waist phenotype, according to sex.
RESULTS
: 112 participants were included, of whom 62.5% were men. The mean age was 61.8 ± 12.3 years and the mean ejection fraction was 40.1 ± 14.7%. Men and woman presented mean HDL-cholesterol of 40.5 ± 14.6 and 40.9 ± 12.7 mg/dl, respectively. The prevalence of the hypertriglyceridemic waist phenotype was 25%. There was a significant difference in mean HDL-cholesterol between men with and without the hypertriglyceridemic waist phenotype (32.8 ± 14.2 versus 42.1 ± 13.7 mg/dl respectively; P = 0.04), even after adjustment for age, body mass index, type 2 diabetes mellitus, use of statins and heart failure etiology.
CONCLUSIONS
: The hypertriglyceridemic waist phenotype is significantly associated with lower HDL-cholesterol levels in men with heart failure.
背景与目的
血清甘油三酯与腰围的联合似乎是心血管风险的良好标志物，并已被命名为“高甘油三酯血症腰围”表型。我们研究的目的是调查心力衰竭患者中高甘油三酯血症腰围表型与高密度脂蛋白胆固醇（HDL-胆固醇）之间的关联。
设计与地点
在巴西南部一家三级医院进行的横断面研究。
方法
我们纳入了年龄大于40岁的心力衰竭患者。进行人体测量评估（体重、身高、腰围和臀围）；计算体重指数（BMI）和腰臀比，并收集血脂测量值（血清总胆固醇、低密度脂蛋白胆固醇、HDL-胆固醇和甘油三酯）。在男性和女性中，腰围分别≥94厘米和≥80厘米，以及甘油三酯≥150毫克/分升被视为异常，并用于识别高甘油三酯血症腰围表型。根据性别，采用协方差分析来评估HDL-胆固醇水平与高甘油三酯血症腰围表型之间的可能关联。
结果
纳入了112名参与者，其中62.5%为男性。平均年龄为61.8±12.3岁，平均射血分数为40.1±14.7%。男性和女性的平均HDL-胆固醇分别为40.5±14.6和40.9±12.7毫克/分升。高甘油三酯血症腰围表型的患病率为25%。即使在调整年龄、体重指数、2型糖尿病、他汀类药物的使用和心力衰竭病因后，有和没有高甘油三酯血症腰围表型的男性之间的平均HDL-胆固醇仍存在显著差异（分别为32.8±14.2与42.1±13.7毫克/分升；P = 0.04）。
结论
高甘油三酯血症腰围表型与心力衰竭男性患者较低的HDL-胆固醇水平显著相关。
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