Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Science, Nagoya, Japan.
Department of Internal Medicine, Faculty of Rehabilitation Science, Nagoya Gakuin University, Nagoya, Japan.
Hypertens Res. 2019 Nov;42(11):1768-1775. doi: 10.1038/s41440-019-0283-x. Epub 2019 Jun 21.
Individuals with metabolic syndrome reportedly have an increased risk of cardiovascular disease, although the association between asymptomatic myocardial damage and metabolic syndrome has not been sufficiently investigated. The present study investigated possible associations between circulating cardiac troponin and metabolic syndrome or related factors. Subjects undergoing their annual health checkups were enrolled in the study (n = 1242). Laboratory measurements included serum high-sensitivity cardiac troponin I (hs-cTnI) and plasma B-type natriuretic peptide (BNP). Individual salt intake was estimated by calculating 24-h urinary sodium excretion from spot urine. Subjects whose electrocardiograms revealed ST-T segment abnormalities or who had renal insufficiency or a history of cardiovascular events were excluded. Subjects with metabolic syndrome had higher hs-cTnI levels than those without, but their BNP levels were equivalent. hs-cTnI levels were significantly associated with the presence and components of metabolic syndrome. Logistic regression analysis with the endpoint of hs-cTnI levels higher than the median value identified metabolic syndrome as an independent determinant of increased hs-cTnI levels. Additionally, urinary salt excretion levels were increased in subjects with metabolic syndrome or any of its components. Logistic regression analysis with the endpoint of metabolic syndrome revealed that hs-cTnI levels were independently associated with the presence of metabolic syndrome. A close association between hs-cTnI levels and the presence of metabolic syndrome, at least partially mediated by increased salt intake, was confirmed to exist in the general population. The findings support the idea that patients with metabolic syndrome develop asymptomatic myocardial damage without obvious ischaemic findings, which leads to increased cardiovascular risk.
据报道,患有代谢综合征的个体患心血管疾病的风险增加,尽管无症状心肌损伤与代谢综合征之间的关联尚未得到充分研究。本研究调查了循环中心肌钙蛋白与代谢综合征或相关因素之间的可能关联。接受年度健康检查的受试者被纳入研究(n=1242)。实验室测量包括血清高敏心肌肌钙蛋白 I(hs-cTnI)和血浆 B 型利钠肽(BNP)。通过计算单次尿样中的 24 小时尿钠排泄量来估计个体盐摄入量。排除心电图显示 ST-T 段异常、肾功能不全或有心血管事件史的受试者。患有代谢综合征的受试者的 hs-cTnI 水平高于没有代谢综合征的受试者,但他们的 BNP 水平相当。hs-cTnI 水平与代谢综合征的存在及其成分显著相关。以 hs-cTnI 水平高于中位数为终点的逻辑回归分析表明,代谢综合征是 hs-cTnI 水平升高的独立决定因素。此外,代谢综合征或其任何成分的受试者的尿盐排泄水平增加。以代谢综合征为终点的逻辑回归分析表明,hs-cTnI 水平与代谢综合征的存在独立相关。hs-cTnI 水平与代谢综合征之间的密切关联,至少部分由盐摄入增加介导,在一般人群中得到证实。这些发现支持这样一种观点,即患有代谢综合征的患者会出现无症状性心肌损伤,而没有明显的缺血发现,从而增加心血管风险。