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血清脂质水平和生活方式与成年人的颈股脉搏波速度有关:一项临床试验的 4.4 年前瞻性纵向随访。

Serum lipid level and lifestyles are associated with carotid femoral pulse wave velocity among adults: 4.4-year prospectively longitudinal follow-up of a clinical trial.

机构信息

a Department of Vascular Medicine , Peking University Shougang Hospital , Beijing , China.

出版信息

Clin Exp Hypertens. 2018;40(5):487-494. doi: 10.1080/10641963.2017.1384486. Epub 2017 Oct 16.

DOI:10.1080/10641963.2017.1384486
PMID:29035100
Abstract

Lifestyle modifications are recommended as the initial treatment for high blood pressure. The influence of dyslipidemia might be via moderate arterial stiffness, which results in hypertension and cardiovascular disease. We used data from a subgroup of the lifestyle, level of serum lipids/carotid femoral-pulse wave velocity (CF-PWV) Susceptibility BEST Study, a population-based study of community-dwelling adults aged 45-75 years. The serum lipid level and CF-PWV were measured at baseline, and lifestyle such as smoking status, sleeping habits, and the level of oil or salt intake was determined with the use of a validated questionnaire during follow-up. Arterial stiffness was determined as CF-PWV using an electrocardiogram after a mean follow-up of 4.4 years. Regression coefficients (95% CIs), adjusted for demographics, risk factors, cholesterol, and triglycerides (TGs), were calculated by linear regression. Logistic regression analysis was used to identify the association between the variables with CF-PWV independently. In the results, glucose and total cholesterol (TC) were associated with higher CF-PWV (p = 0.000) and lower-destiny lipoprotein was associated with lower CF-PWV (p = 0.001) after adjustments for age, sex, mean arterial pressure, and heart rate. There were significant associations observed for current salt intake in relation to CF-PWV (p-trend = 0.038) without adjustment. This association was retained after adjustments for covariates and had statistical significance (p-trend = 0.048) in model 3, which adjusted age, sex, baseline CF-PWV, mean arterial pressure, heart rate waist circumference, education, smoking status, physical activity, diabetes mellitus (DM), heart disease, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, TGs, antihypertensive medicine, nitrate medicine, and antiplatelet medicine. Linear regression showed statistically significant associations between LDL and CF-PWV in the fully adjusted models (model 1 p = 0.010, model 2 p = 0.020, model 3 p = 0.017). Logistic regression analysis showed that CF-PWV was independently associated with age (p = 0.000), TC (p = 0.000), TGs (p = 0.000), and homo-cysteine (p = 0.000), and their odds ratios were 0.781, 3.424, 0.075, and 1.046, respectively. Our results showed a positive association between LDL and arterial stiffness, and suggested that less smoking status, sleeping disorder, and salt intake were associated with less arterial stiffness.

摘要

生活方式的改变被推荐作为高血压的初始治疗方法。血脂异常的影响可能是通过中度动脉僵硬导致高血压和心血管疾病。我们使用了来自生活方式、血脂/颈动脉股动脉脉搏波速度(CF-PWV)易感性最佳研究的亚组数据,这是一项针对 45-75 岁社区居住成年人的基于人群的研究。在基线时测量血清脂质水平和 CF-PWV,并在随访期间使用经过验证的问卷确定生活方式,如吸烟状况、睡眠习惯以及油或盐的摄入量。使用心电图在平均随访 4.4 年后确定动脉僵硬程度为 CF-PWV。通过线性回归计算调整年龄、危险因素、胆固醇和甘油三酯(TGs)后的回归系数(95%置信区间)。使用逻辑回归分析独立识别与 CF-PWV 相关的变量之间的关联。结果表明,葡萄糖和总胆固醇(TC)与较高的 CF-PWV 相关(p=0.000),而较低的脂蛋白与较低的 CF-PWV 相关(p=0.001),调整年龄、性别、平均动脉压和心率后。未经调整时,当前盐摄入量与 CF-PWV 呈显著相关(p 趋势=0.038)。在模型 3 中,调整年龄、性别、基线 CF-PWV、平均动脉压、心率、腰围、教育程度、吸烟状况、体力活动、糖尿病(DM)、心脏病、高密度脂蛋白(HDL)胆固醇、低密度脂蛋白(LDL)胆固醇、TGs、降压药、硝酸盐药物和抗血小板药物后,这种相关性仍然存在且具有统计学意义(p 趋势=0.048)。线性回归显示,在完全调整模型中,LDL 与 CF-PWV 之间存在统计学显著关联(模型 1 p=0.010,模型 2 p=0.020,模型 3 p=0.017)。逻辑回归分析显示,CF-PWV 与年龄(p=0.000)、TC(p=0.000)、TGs(p=0.000)和同型半胱氨酸(p=0.000)独立相关,其比值比分别为 0.781、3.424、0.075 和 1.046。我们的结果表明 LDL 与动脉僵硬之间存在正相关,并表明吸烟状况较少、睡眠障碍和盐摄入量较少与动脉僵硬程度较低有关。

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