a Head of research laboratory Epidemiology of non-communicable diseases , Almazov National Medical Research Centre , Saint Petersburg , Russia.
Clin Exp Hypertens. 2018;40(5):421-426. doi: 10.1080/10641963.2017.1384488. Epub 2017 Oct 25.
To assess the association of metabolic syndrome (MS) and its components with target organ damage in a follow-up study of relatively healthy bank employers.
Out of 1600 random samples of office workers in Saint Petersburg (Russia), a group of 383 participants with at least one component of MS and without cardiovascular complications was selected (mean age 46.6 ± 9.0 years, 214 females (64.6%)). Follow-up visit was performed in 331 subjects. Target organ damage (TOD) was assessed by echocardiography, carotid ultrasound, applanational tonometry, brachial-ankle index, and urine albumin excretion measurements. Anthropometry, vital signs, and biochemistry were performed according to standard protocols.
Presence of MS was not associated with higher probability of TOD. Multiple linear regression revealed significant association of all markers of TOD with older age. Hypertension was a significant predictor of left ventricular hypertrophy (LVH), increased arterial stiffness, and early signs of carotid atherosclerosis in logistic regression adjusted for age and gender. During follow-up, proportion of patients with LVH significantly decreased (from 46.7% to 32.9%, р = 0.003) and prevalence of patients with IMT > 0.09 сm increased (from 24.5% to 44.1%, p < 0.001) accompanying by significant declining of office blood pressure (BP) and total cholesterol.
MS per se is not related to increased probability to TOD. Hypertension, female gender, and older age are main determinants of subclinical changes. After 2-years follow-up, significant LVH and renal damage regression was observed probably owing to BP reduction. Alternatively, early signs of carotid atherosclerosis increase with aging despite decreasing of the prevalence of hypercholesterolemia.
在一项针对相对健康的银行雇主的随访研究中，评估代谢综合征（MS）及其成分与靶器官损伤之间的关系。
在圣彼得堡（俄罗斯）的 1600 名办公室工作人员中随机抽取 383 名至少有一个 MS 成分且无心血管并发症的参与者（平均年龄 46.6±9.0 岁，214 名女性[64.6%]）。对 331 名受试者进行了随访。通过超声心动图、颈动脉超声、平板眼压计、肱踝指数和尿白蛋白排泄测量评估靶器官损伤（TOD）。根据标准方案进行人体测量、生命体征和生物化学检查。
MS 的存在与 TOD 的可能性增加无关。多元线性回归显示，TOD 的所有标志物均与年龄较大显著相关。高血压是左心室肥厚（LVH）、动脉僵硬度增加和颈动脉粥样硬化早期迹象的显著预测因素，在调整年龄和性别后进行逻辑回归。随访期间，LVH 患者的比例显著下降（从 46.7%降至 32.9%，p=0.003），而 IMT>0.09 cm 的患者比例增加（从 24.5%增至 44.1%，p<0.001），同时办公室血压（BP）和总胆固醇显著降低。
MS 本身与增加 TOD 的可能性无关。高血压、女性和年龄较大是亚临床变化的主要决定因素。在 2 年随访后，观察到显著的 LVH 和肾脏损伤消退，可能归因于血压降低。或者，尽管高胆固醇血症的患病率降低，但颈动脉粥样硬化的早期迹象仍会随年龄增长而增加。
