动脉僵硬度及其与代谢综合征危险因素聚集的关联。
Arterial stiffness and its association with clustering of metabolic syndrome risk factors.
作者信息
Lopes-Vicente Wanda R P, Rodrigues Sara, Cepeda Felipe X, Jordão Camila Paixão, Costa-Hong Valéria, Dutra-Marques Akothirene C B, Carvalho Jefferson C, Alves Maria Janieire N N, Bortolotto Luiz A, Trombetta Ivani C
机构信息
Universidade Nove de Julho (UNINOVE), Programa de Pós Graduação em Medicina, Rua Vergueiro 235/249, São Paulo, CEP 01504-001 Brazil.
Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
出版信息
Diabetol Metab Syndr. 2017 Oct 25;9:87. doi: 10.1186/s13098-017-0286-1. eCollection 2017.
BACKGROUND
Metabolic syndrome (MetS) is associated with structural and functional vascular abnormalities, which may lead to increased arterial stiffness, more frequent cardiovascular events and higher mortality. However, the role played by clustering of risk factors and the combining pattern of MetS risk factors and their association with the arterial stiffness have yet to be fully understood. Age, hypertension and diabetes mellitus seem to be strongly associated with increased pulse wave velocity (PWV). This study aimed at determining the clustering and combining pattern of MetS risk factors and their association with the arterial stiffness in non-diabetic and non-hypertensive patients.
METHODS
Recently diagnosed and untreated patients with MetS (n = 64, 49 ± 8 year, 32 ± 4 kg/m) were selected, according to ATP III criteria and compared to a control group (Control, n = 17, 49 ± 6 year, 27 ± 2 kg/m). Arterial stiffness was evaluated by PWV in the carotid-femoral segment. Patients were categorized and analyzed according MetS risk factors clustering (3, 4 and 5 factors) and its combinations.
RESULTS
Patients with MetS had increased PWV when compared to Control (7.8 ± 1.1 vs. 7.0 ± 0.5 m/s, p < 0.001). In multivariate analysis, the variables that remained as predictors of PWV were age (β = 0.450, p < 0.001), systolic blood pressure (β = 0.211, p = 0.023) and triglycerides (β = 0.212, p = 0.037). The increased number of risk factors reflected in a progressive increase in PWV. When adjusted to systolic blood pressure, PWV was greater in the group with 5 risk factors when compared to the group with 3 risk factors and Control (8.5 ± 0.4 vs. 7.5 ± 0.2, p = 0.011 and 7.2 ± 0.3 m/s, p = 0.012). Similarly, the 4 risk factors group had higher PWV than the Control (7.9 ± 0.2 vs. 7.2 ± 0.3, p = 0.047).
CONCLUSIONS
The number of risk factors seems to increase arterial stiffness. Notably, besides age and increased systolic blood pressure, alterations in the triglycerides worsened the stiffness of large vessels, emphasizing the importance in addressing this risk factor in MetS patients.
背景
代谢综合征（MetS）与血管结构和功能异常相关，这可能导致动脉僵硬度增加、心血管事件更频繁发生以及死亡率更高。然而，风险因素聚集所起的作用、MetS风险因素的组合模式及其与动脉僵硬度的关联尚未完全明确。年龄、高血压和糖尿病似乎与脉搏波速度（PWV）增加密切相关。本研究旨在确定非糖尿病和非高血压患者中MetS风险因素的聚集和组合模式及其与动脉僵硬度的关联。
方法
根据ATP III标准，选取近期诊断且未接受治疗的MetS患者（n = 64，年龄49±8岁，体重指数32±4 kg/m²），并与对照组（对照组，n = 17，年龄49±6岁，体重指数27±2 kg/m²）进行比较。通过测量颈股段的PWV评估动脉僵硬度。根据MetS风险因素聚集情况（3个、4个和5个因素）及其组合对患者进行分类和分析。
结果
与对照组相比，MetS患者的PWV升高（7.8±1.1 vs. 7.0±0.5 m/s，p < 0.001）。在多变量分析中，仍作为PWV预测因素的变量为年龄（β = 0.450，p < 0.001）、收缩压（β = 0.211，p = 0.023）和甘油三酯（β = 0.212，p = 0.037）。风险因素数量的增加反映为PWV的逐渐升高。调整收缩压后，与3个风险因素组和对照组相比，5个风险因素组的PWV更高（8.5±0.4 vs. 7.5±0.2，p = 0.011和7.2±0.3 m/s，p = 0.012）。同样，4个风险因素组的PWV高于对照组（7.9±0.2 vs. 7.2±
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