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[社区居民中心外膜脂肪组织与心血管危险因素及冠状动脉钙化的关联]

[Association of epicardial adipose tissue with cardiovascular risk factors and coronary artery calcification in the community residents].

作者信息

Zhang H H, Meng X B, Wang W Y, Zhang K, Qi Y, An S M, Wang S Y, Zheng J L, Wu J, Zhou Y, Gao C Y, Tang Y D

机构信息

Department of Internal Medicine, Coronary Heart Disease Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2018 May 24;46(5):364-369. doi: 10.3760/cma.j.issn.0253-3758.2018.05.008.

Abstract

This cross-sectional study aimed to address the relationship between the volume of epicardial adipose tissue (EAT) with cardiovascular risk factors and coronary artery calcification(CAC) in the community residents. Individuals were recruited from the Jidong Community (Tangshan City, Northern China) which mainly comprised employees of the Jidong Co. Ltd. and their family members. From July 2013 to August 2014, 2 647 participants aged ≥40 years were included in this study. The volume of EAT and coronary artery calcification score (CAC score) were determined by a 64-slice CT. Carotid intima-media thickness (CIMT) was measured by a trained sonographer using a high-resolution B-mode topographic ultrasound system. Venous blood samples were analyzed by automated analyzers in the central laboratory. A validated questionnaire specifically designed for this study was used to collect demographic data from all participants by trained doctors. Characteristics of study cohort were compared according to quartiles of EAT volume (660, 663, 662, 662, repectively). (1) The mean age of participants was (55.31±7.76) years and 49.94% (1 322) were men. The median EAT volume (interquartile) was 129.42 (95.66, 176.51)cm(3). (2) Age, BMI, waist circumference and hip circumference, systolic blood pressure, LDL-C, triglycerides, and fasting blood glucose were significantly higher, while HDL-C level was significantly lower in participants with higher EAT volume than participants with lower EAT volume (all <0.05). Carotid intima-media thicken (CIMT) and higher CAC score were also significantly higher in participants with higher volume of EAT. Furthermore, percentage of diabetes mellitus, hypertension, hyperlipidemia increased in proportion with increasing EAT volume (<0.05). (3) In the linear regression, significant positive relations were found for age (β=0.019 3, 95% 0.017-0.021, <0.001), waist circumference (β=0.012 7, 95% 0.009-0.016, <0.001), BMI (β=0.022 4, 95% 0.013-0.032, <0.001), LDL-C (β=0.048 4, 95% 0.021-0.076, <0.001), and HDL-C (β=-0.098 1, 95%-0.164--0.032, <0.001) was inversely related to the EAT volume. (4) Logistic regression analysis indicated that EAT volume was an independent risk factor for CAC score>0 (1.233, 95% 1.205-1.262, <0.001) . Our findings indicate that EAT volume is strongly correlated to cardiovascular risk factors and coronary calcification and is an independent risk factor of increased coronary calcification in community residents.

摘要

这项横断面研究旨在探讨社区居民中心外膜脂肪组织(EAT)体积与心血管危险因素及冠状动脉钙化(CAC)之间的关系。研究对象来自冀东社区(中国北方唐山市),主要包括冀东有限公司的员工及其家属。2013年7月至2014年8月,本研究纳入了2647名年龄≥40岁的参与者。EAT体积和冠状动脉钙化评分(CAC评分)通过64层CT确定。颈动脉内膜中层厚度(CIMT)由经过培训的超声检查人员使用高分辨率B型超声系统测量。静脉血样本在中心实验室通过自动分析仪进行分析。由经过培训的医生使用专门为本研究设计并经过验证的问卷收集所有参与者的人口统计学数据。根据EAT体积四分位数(分别为660、663、662、662)比较研究队列的特征。(1)参与者的平均年龄为(55.31±7.76)岁,男性占49.94%(1322人)。EAT体积的中位数(四分位间距)为129.42(95.66,176.51)cm³。(2)EAT体积较高的参与者的年龄、体重指数、腰围和臀围、收缩压、低密度脂蛋白胆固醇、甘油三酯和空腹血糖显著更高,而高密度脂蛋白胆固醇水平显著更低(均P<0.05)。EAT体积较高的参与者的颈动脉内膜中层增厚(CIMT)和较高的CAC评分也显著更高。此外,糖尿病、高血压、高脂血症的比例随EAT体积增加而增加(P<0.05)。(3)在线性回归中,发现年龄(β=0.019 3,95%CI 0.017 - 0.021,P<0.001)、腰围(β=0.012 7,95%CI 0.009 - 0.016,P<0.001)、体重指数(β=0.022 4,95%CI 0.013 - 0.032,P<0.001)、低密度脂蛋白胆固醇(β=0.048 4,95%CI 0.021 - 0.076,P<0.001)与EAT体积呈显著正相关,而高密度脂蛋白胆固醇(β=-0.098 1,95%CI - 0.164 - - 0.032,P<0.001)与EAT体积呈负相关。(4)逻辑回归分析表明,EAT体积是CAC评分>0的独立危险因素(1.233,95%CI 1.205 - 1.262,P<0.001)。我们的研究结果表明,EAT体积与心血管危险因素和冠状动脉钙化密切相关,并且是社区居民冠状动脉钙化增加的独立危险因素。

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