腰臀比增加是超重人群动脉粥样硬化负担的一个关键决定因素。
An increased waist-to-hip ratio is a key determinant of atherosclerotic burden in overweight subjects.
机构信息
Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi Hospital, University of Catania, Via Palermo 636, 95122, Catania, Italy.
Cardiovascular Prevention Unit, of Metabolism and Endocrinology Service; Paris Hospital Public Assistance, Pitié-Salpêtrière Hospital Group - Pierre et Marie Curie University, Paris, France.
出版信息
Acta Diabetol. 2018 Jul;55(7):741-749. doi: 10.1007/s00592-018-1144-9. Epub 2018 Apr 21.
AIMS
The association of overweight status and cardiovascular disease is not clear. In this study we aimed to investigate coronary atherosclerotic disease, evaluated as coronary artery calcium score (CACs), in overweight patients with or without abdominal obesity as defined by waist-to-hip ratio (WHR).
METHODS
We enrolled 276 patients aged between 40 and 70 years, with a body mass index of 25-29.9 kg/m and at least one cardiovascular risk factor. Exclusion criteria were history of diabetes, cardiovascular or renal disease. Patients were stratified in high WHR (H-WHR) or low WHR (L-WHR) group according to WHR (≥ 0.85 for women and ≥ 0.90 for men) and underwent multi-detector computed tomography for CACs. Mean carotid intima-media thickness (IMT) and plaque presence were equally assessed.
RESULTS
CACs was higher in the H-WHR group compared to L-WHR (9.05 [0.0-83.48] vs 0.0 [0.0-64.7] AU, p < 0.01); the prevalence of CACs > 0 in the H-WHR group was significantly higher than subjects with L-WHR (59.6% vs 38.5%, p < 0.001). Moreover, H-WHR group had higher mean IMT (0.64 [0.56-0.72] vs 0.59 [0.55-0.67] mm, p < 0.05) and higher carotid plaque prevalence (63.7% vs 50.8%, p < 0.05) compared to subjects with L-WHR. Logistic regression showed that H-WHR was associated with presence of CACs and carotid plaque (p < 0.01). In a multiple linear regression, WHR was positively associated with CACs and IMT (p < 0.01).
CONCLUSIONS
H-WHR is a marker of coronary and peripheral atherosclerotic burden in overweight patients.
目的
超重与心血管疾病的关联尚不清楚。本研究旨在探讨超重患者（按腰围与臀围比定义）的冠状动脉粥样硬化疾病（以冠状动脉钙评分 CACs 评估），这些患者分为中心性肥胖（H-WHR）和非中心性肥胖（L-WHR）。
方法
我们纳入了 276 名年龄在 40 至 70 岁之间、体质指数为 25-29.9kg/m²且至少有一个心血管危险因素的患者。排除标准为糖尿病、心血管或肾脏疾病病史。根据腰围与臀围比（女性≥0.85，男性≥0.90）将患者分为 H-WHR 或 L-WHR 组，然后对所有患者进行多排螺旋 CT 检查以评估 CACs。同时评估平均颈动脉内膜中层厚度（IMT）和斑块的存在情况。
结果
与 L-WHR 组相比，H-WHR 组的 CACs 更高（9.05 [0.0-83.48] 与 0.0 [0.0-64.7] AU，p<0.01）；H-WHR 组 CACs>0 的发生率明显高于 L-WHR 组（59.6% 比 38.5%，p<0.001）。此外，H-WHR 组的平均 IMT 更高（0.64 [0.56-0.72] 与 0.59 [0.55-0.67] mm，p<0.05），颈动脉斑块的发生率更高（63.7% 比 50.8%，p<0.05）。与 L-WHR 组相比，H-WHR 与 CACs 和颈动脉斑块的存在相关（p<0.01）。在多元线性回归中，H-WHR 与 CACs 和 IMT 呈正相关（p<0.01）。
结论
H-WHR 是超重患者冠状动脉和外周动脉粥样硬化负担的标志物。
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