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评估代谢综合征相关的动脉僵硬与明显健康男性的胰岛素抵抗。

Assessment of Arterial Stiffness in Metabolic Syndrome Related to Insulin Resistance in Apparently Healthy Men.

机构信息

1 Epidemiology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.

2 Department of Nephrology, John Hunter Hospital, University of Newcastle, New South Wales, Australia.

出版信息

Metab Syndr Relat Disord. 2019 Mar;17(2):90-96. doi: 10.1089/met.2018.0090. Epub 2019 Jan 8.

Abstract

BACKGROUND

Assessment of subclinical atherosclerosis in metabolic syndrome is one of the global health targets' priorities. This study aimed to evaluate the subclinical atherosclerosis in metabolic syndrome related to insulin resistance in healthy and physically active men.

METHODS

A consecutive group of 68 healthy men, 30-55 years of age, was studied. Anthropometric parameters, proinflammatory factors, and insulin level were measured, and pulse wave analysis (PWA) was performed by applanation tonometry and then processed with dedicated software (SphygmoCor). The metabolic syndrome was defined according to International Diabetes Federation (IDF) and metabolic health as ≤1 component of metabolic syndrome according to the Joint Interim Statement criteria.

RESULTS

The odds ratio of insulin resistance for metabolic syndrome was 5.16 (95% confidence interval: 1.44-18.5), P = 0.008. In PWA, metabolically healthy subjects had lower aortic systolic and diastolic, and cardiac end-systolic pressures (103.5 ± 9.9 vs. 108.8 ± 11.0), P = 0.03, (76.2 ± 8.8 vs. 80.6 ± 7.8), P = 0.04, and (96.5 ± 9.2 vs. 101 ± 10.1), P = 0.05, respectively. Furthermore, metabolic syndrome was accompanied by higher ejection duration% (38.8 ± 3.5 vs. 36.9 ± 2.8), P = 0.04, and lower subendocardial viability ratio (SEVR) (139.8 ± 17.7 vs. 150.9 ± 17.6), P = 0.05. Insulin resistance was associated with higher cardiac end-systolic pressure (103.0 ± 6.9 vs. 96.7 ± 10.4), P = 0.015.

CONCLUSION

Metabolic risk factors had incremental correlations with central arterial pressures and cardiac end-systolic pressure. Furthermore, the composite of metabolic syndrome components imposed additional load on cardiac muscle by higher cardiac ejection duration and impairment in perfusion with lower Buckberg SEVR. Likewise, insulin resistance could be an early marker of arterial stiffness in healthy and active young to middle-age men.

摘要

背景

评估代谢综合征患者的亚临床动脉粥样硬化是全球健康目标的优先事项之一。本研究旨在评估代谢综合征相关的胰岛素抵抗与健康、活跃的中年男性的亚临床动脉粥样硬化的关系。

方法

研究连续纳入 68 名年龄在 30-55 岁的健康男性。测量了人体测量参数、促炎因子和胰岛素水平,并通过平板张力测量法进行脉搏波分析(PWA),然后使用专用软件(SphygmoCor)进行处理。代谢综合征根据国际糖尿病联合会(IDF)定义,代谢健康根据联合临时声明标准定义为代谢综合征的任何一个成分均不超过 1 个。

结果

胰岛素抵抗与代谢综合征的比值比为 5.16(95%置信区间:1.44-18.5),P=0.008。在 PWA 中,代谢健康的受试者主动脉收缩压和舒张压以及心脏收缩末期压力较低(103.5±9.9 比 108.8±11.0),P=0.03;(76.2±8.8 比 80.6±7.8),P=0.04;(96.5±9.2 比 101±10.1),P=0.05。此外,代谢综合征伴有更高的射血持续时间百分比(38.8±3.5 比 36.9±2.8),P=0.04;和更低的心内膜下活力比(SEVR)(139.8±17.7 比 150.9±17.6),P=0.05。胰岛素抵抗与较高的心脏收缩末期压力相关(103.0±6.9 比 96.7±10.4),P=0.015。

结论

代谢风险因素与中心动脉压和心脏收缩末期压力呈递增相关。此外,代谢综合征各组成部分通过较高的心脏射血持续时间和较低的 Buckberg SEVR 导致灌注受损,从而对心肌造成更大的负荷。同样,胰岛素抵抗可能是健康活跃的中年男性动脉僵硬的早期标志物。

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