Zanoli L, Di Pino A, Terranova V, Di Marca S, Pisano M, Di Quattro R, Ferrara V, Scicali R, Rabuazzo A M, Fatuzzo P, Castellino P, Piro S, Purrello F, Malatino L
Nephrology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Internal Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Nutr Metab Cardiovasc Dis. 2018 Dec;28(12):1222-1229. doi: 10.1016/j.numecd.2018.08.003. Epub 2018 Aug 23.
Metabolic syndrome (MetS) is currently considered to raise the risk for type 2 diabetes and cardiovascular events. It has been suggested that part of this risk excess may be due to a cluster of additional factors associated with MetS. We aimed to investigate the role of inflammation on the ventricular-vascular coupling in patients with MetS.
We enrolled a total of 227 hypertensive patients (106 with MetS and 121 without MetS) matched for age and gender. Aortic pulse wave velocity (aPWV), intima-media thickness (IMT) and high sensitivity C-reactive protein (CRP) increased according to the number of MetS components. Patients with MetS showed increased aPWV (11.5 ± 3.7 vs. 10.3 ± 2.5 m/s, P = 0.03) compared with controls. In a model adjusted for age, sex, heart rate and mean blood pressure, aPWV resulted increased in patients with CKD (beta 1.29 m/s, 95%CI 0.61-1.96 m/s, P < 0.001) and MetS (beta 0.89 m/s, 95%CI 0.28-1.51 m/s, P = 0.005). After additional adjustment for CRP and IMT, the slope of aPWV was respectively reduced by 16% and 62%, suggesting that inflammation and intima-media thickening could contribute to aortic stiffening in patients with MetS. In these patients, aPWV was also associated with left-ventricular mass index (beta 0.79 g/m, 95%CI 0.05-1.52 g/m, P = 0.05).
MetS is characterized by an inflammation-dependent acceleration in cardiovascular ageing. This pattern of pathophysiological abnormalities may contribute to amplify the burden of cardiovascular risk in patients with MetS.
代谢综合征（MetS）目前被认为会增加2型糖尿病和心血管事件的风险。有人提出，这种额外风险的一部分可能归因于与MetS相关的一系列其他因素。我们旨在研究炎症在MetS患者心室-血管耦联中的作用。
我们共纳入了227例年龄和性别相匹配的高血压患者（106例患有MetS，121例未患MetS）。主动脉脉搏波速度（aPWV）、内膜中层厚度（IMT）和高敏C反应蛋白（CRP）随MetS组分数量的增加而升高。与对照组相比，患有MetS的患者aPWV升高（11.5±3.7 vs. 10.3±2.5 m/s，P = 0.03）。在对年龄、性别、心率和平均血压进行校正的模型中，慢性肾脏病（CKD）患者（β 1.29 m/s，95%置信区间0.61 - 1.96 m/s，P < 0.001）和MetS患者（β 0.89 m/s，95%置信区间0.28 - 1.51 m/s，P = 0.005）的aPWV升高。在进一步对CRP和IMT进行校正后，aPWV的斜率分别降低了16%和62%，这表明炎症和内膜中层增厚可能导致MetS患者的主动脉硬化。在这些患者中，aPWV还与左心室质量指数相关（β 0.79 g/m，95%置信区间0.05 - 1.52 g/m，P = 0.05）。
MetS的特征是心血管衰老过程中炎症依赖性加速。这种病理生理异常模式可能会加重MetS患者的心血管风险负担。
