代谢综合征伴严重高甘油三酯血症患者的动脉功能参数。

Arterial function parameters in patients with metabolic syndrome and severe hypertriglyceridemia.

机构信息

Department of Cardiovascular Medicine, Vilnius University, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania; Experimental and Clinical Medicine Research Institute, Vilnius University, Vilnius, Lithuania.

Vilnius University Medical Faculty, Vilnius, Lithuania.

出版信息

J Clin Lipidol. 2017 Jul-Aug;11(4):901-907. doi: 10.1016/j.jacl.2017.04.119. Epub 2017 May 4.

DOI:10.1016/j.jacl.2017.04.119

PMID:28595894

Abstract

BACKGROUND

Hypertriglyceridemia (hTG) is 1 of the dyslipidemia manifestations in patients with metabolic syndrome (MetS). However, for several decades, the role of hTG in cardiovascular risk was not well established.

OBJECTIVE

The aim of this study was to assess the parameters of the vascular structure and function in patients with MetS and different degree of hTG.

METHODS

Patients (aged 40-65 years) with MetS were divided into 3 groups by triglyceride (TG) levels according to National Cholesterol Education Program Adult Treatment Panel III Guidelines: severe hTG (TG ≥ 500 mg/dL), moderate hTG (TG 200-499 mg/dL), and a control (TG < 150 mg/dL) groups. Noninvasive assessment of vascular parameters (aortic augmentation index adjusted for heart rate 75 bpm [AixHR75], pulse wave velocity [PWV], flow-mediated dilatation, and common carotid artery intima-media thickness (IMT)) were performed.

RESULTS

Among the 1938 patients analyzed, 1041 had hTG. Moderate hTG was observed in 90.40% (n = 941), whereas severe TG was observed in 9.6% (n = 100) of patients. Overall TG concentration was 231.17 ± 184.23 mg/dL; in severe hTG group, TG concentration was 795.36 ± 368.45 mg/dL, in moderate hTG group 285.20 ± 70.86 mg/dL, and 112.48 ± 24.80 mg/dL in control group. AIxHR75 and IMT were the lowest in the severe hTG group (P < .001 for both). Mean arterial pressure, carotid-radial PWV (9.25 ± 1.13 vs 9.24 ± 1.28 vs 8.91 ± 1.28; P < .001) as well as carotid-femoral PWV (8.63 ± 1.65 vs 8.75 ± 1.58 vs 8.51 ± 1.6; P = .006) were the higher in hTG groups compared with control. There were no significant differences between groups in flow-mediated dilatation (3.39 ± 2.01 vs 3.26 ± 2.43 vs 3.45 ± 2.61, P = .283).

CONCLUSIONS

Patients with MetS and severe hTG have lower IMT and AIxHR75 and higher PWV and mean arterial pressure. Many factors could affect arterial parameters, and more research are needed to investigate arterial parameters and hTG connection.

摘要

背景

高甘油三酯血症（hTG）是代谢综合征（MetS）患者血脂异常的表现之一。然而，几十年来，hTG 在心血管风险中的作用尚未得到充分证实。

目的

本研究旨在评估 MetS 患者和不同程度 hTG 患者的血管结构和功能参数。

方法

根据美国国家胆固醇教育计划成人治疗专家组 III 指南，将患有 MetS 的患者（年龄 40-65 岁）按甘油三酯（TG）水平分为 3 组：严重 hTG（TG≥500mg/dL）、中度 hTG（TG200-499mg/dL）和对照组（TG<150mg/dL）。进行血管参数的无创评估（心率为 75 次/分时的主动脉增强指数校正[ AixHR75]、脉搏波速度[PWV]、血流介导的扩张和颈总动脉内膜-中层厚度（IMT））。

结果

在分析的 1938 名患者中，有 1041 名患者存在 hTG。中度 hTG 占 90.40%（n=941），而严重 hTG 占 9.6%（n=100）。总体 TG 浓度为 231.17±184.23mg/dL；严重 hTG 组 TG 浓度为 795.36±368.45mg/dL，中度 hTG 组为 285.20±70.86mg/dL，对照组为 112.48±24.80mg/dL。AixHR75 和 IMT 在严重 hTG 组最低（均 P<.001）。与对照组相比，平均动脉压、颈动脉-桡动脉 PWV（9.25±1.13 vs 9.24±1.28 vs 8.91±1.28；P<.001）和颈动脉-股动脉 PWV（8.63±1.65 vs 8.75±1.58 vs 8.51±1.6；P=0.006）在 hTG 组更高。在血流介导的扩张方面，各组之间没有显著差异（3.39±2.01 vs 3.26±2.43 vs 3.45±2.61，P=0.283）。