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通过雷诺兹风险评分评估的心血管风险与黑山明显健康的中年人群腰围的关系

Cardiovascular Risk Assessed by Reynolds Risk Score in Relation to Waist Circumference in Apparently Healthy Middle-Aged Population in Montenegro.

作者信息

Klisić Aleksandra, Kavarić Nebojša, Bjelaković Bojko, Jovanović Milovan, Zvrko Elvir, Stanišić Verica, Ninić Ana, Šćepanović Anđelka

机构信息

Primary Health Care Center, Podgorica, Montenegro.

University Department of Pediatrics, Faculty of Medicine, University of Niš, Niš, Serbia.

出版信息

Acta Clin Croat. 2018 Mar;57(1):22-30. doi: 10.20471/acc.2018.57.01.03.

Abstract

Reynolds Risk Score (RRS) is regarded as a good screening tool for cardiovascular disease (CVD) risk. Since CVD is the leading cause of death in Montenegro, we aimed to assess the risk of CVD as assessed by RRS and to examine its association with cardiometabolic parameters in apparently healthy middle-aged population. In addition, we aimed to test whether obesity had an independent influence on RRS. A total of 132 participants (mean age 56.2±6.73 years, 69% females) were included. Body mass index (BMI), waist circumference (WC), blood pressure (BP) and biochemical parameters (fasting glucose, insulin, lipid parameters, creatinine and high sensitivity C-reactive protein) were determined. Insulin resistance (HOMA-IR) and glomerular filtration rate (eGFR) were calculated. Compared with females, a significantly higher number of males were in the high RRS subgroup (χ2=45.9, p<0.001). Furthermore, significantly higher fasting glucose (p=0.030), insulin, HOMA-IR, triglycerides (p<0.001 all), anthropometric parameters (e.g., BMI and WC; p=0.004 and p<0.001, respectively), and creatinine, but lower eGFR and HDL-c (p<0.001 both) were recorded in the high-risk subgroup compared with low and medium risk subgroups. In all participants, in addition to LDL-c, diastolic BP and creatinine, WC was independently positively associated with RRS (β=0.194, p=0.006; β=0.286, p=0.001; β=0.267, p=0.001; and β=0.305, p=0.019, respectively), and 40% of variation in RRS could be explained with this model. In conclusion, middle-aged population with higher WC should be screened for RRS in order to estimate CVD risk.

摘要

雷诺兹风险评分(RRS)被视为心血管疾病(CVD)风险的良好筛查工具。由于CVD是黑山共和国的主要死因,我们旨在评估RRS所评估的CVD风险,并研究其与明显健康的中年人群中心血管代谢参数的关联。此外,我们旨在测试肥胖是否对RRS有独立影响。共纳入132名参与者(平均年龄56.2±6.73岁,69%为女性)。测定了体重指数(BMI)、腰围(WC)、血压(BP)和生化参数(空腹血糖、胰岛素、血脂参数、肌酐和高敏C反应蛋白)。计算了胰岛素抵抗(HOMA-IR)和肾小球滤过率(eGFR)。与女性相比,高RRS亚组中的男性数量显著更多(χ2=45.9,p<0.001)。此外,与低风险和中等风险亚组相比,高风险亚组中空腹血糖(p=0.030)、胰岛素、HOMA-IR、甘油三酯(均p<0.001)、人体测量参数(如BMI和WC;分别为p=0.004和p<0.001)以及肌酐显著更高,但eGFR和高密度脂蛋白胆固醇(HDL-c)更低(均p<0.001)。在所有参与者中,除了低密度脂蛋白胆固醇(LDL-c)、舒张压和肌酐外,WC与RRS独立正相关(β=0.194,p=0.006;β=0.286,p=0.001;β=0.267,p=0.001;以及β=0.305,p=0.019),该模型可解释RRS中40%的变异。总之,WC较高的中年人群应进行RRS筛查,以评估CVD风险。

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