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代谢综合征与男性外周血管内皮功能障碍有关。

Metabolic syndrome is associated with peripheral endothelial dysfunction amongst men.

作者信息

Taher Riad, Sara Jaskanwal D, Heidari Behnam, Toya Takumi, Lerman Lilach O, Lerman Amir

机构信息

Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

出版信息

Diabetes Metab Syndr Obes. 2019 Jul 5;12:1035-1045. doi: 10.2147/DMSO.S204666. eCollection 2019.

Abstract

Metabolic syndrome (MetS) and peripheral endothelial dysfunction (PED) are both independently associated with an increased risk of cardiovascular disease (CVD). PED provides prognostic information beyond that provided by conventional risk factors. However, the association between MetS and PED remains uncertain. We evaluated the association between MetS and PED. We performed a retrospective analysis of patients who were referred to Mayo Clinic between 2006 and 2014 for evaluation of chest pain and/or an assessment of CVD risk that included an assessment of PED measured with reactive hyperemia peripheral arterial tonometry. MetS was defined as the presence of at least 3 of the following: body mass index25 kg/m, impaired fasting glucose or diabetes, high blood pressure or hypertension, hypertriglyceridemia, or low high-density lipoprotein cholesterol. Six hundred seventy-eight patients were included (mean age 51.9±13.5 years, 418 (61.6%) women), of which 293 (43.2%) had PED, and 249 (36.7%) had MetS. In multivariable analyses adjusted for age, sex, CVD, smoking status, and elevated low-density lipoprotein, MetS was significantly associated with PED (Odds Ratio (OR) 2.06; =0.0090). Of the individual MetS components, only being overweight and MetS range high-density lipoprotein had a similar association. After stratifying by sex, the association between MetS and PED persisted only in men (OR 3.16, =0.0094). MetS is associated with PED in men undergoing an assessment of chest pain and/or CVD risk. Identifying PED in individuals with MetS could provide an abridged assessment of risk, potentially allowing for earlier and more intensive management of risk factors.

摘要

代谢综合征(MetS)和外周血管内皮功能障碍(PED)均与心血管疾病(CVD)风险增加独立相关。PED所提供的预后信息超出了传统危险因素所提供的信息。然而,MetS与PED之间的关联仍不确定。我们评估了MetS与PED之间的关联。我们对2006年至2014年间因胸痛评估和/或CVD风险评估(包括通过反应性充血外周动脉张力测定法评估PED)而转诊至梅奥诊所的患者进行了回顾性分析。MetS定义为存在以下至少3项:体重指数≥25kg/m²、空腹血糖受损或糖尿病、高血压、高甘油三酯血症或低高密度脂蛋白胆固醇。纳入了678例患者(平均年龄51.9±13.5岁,418例(61.6%)为女性),其中293例(43.2%)有PED,249例(36.7%)有MetS。在对年龄、性别、CVD、吸烟状况和低密度脂蛋白升高进行校正的多变量分析中,MetS与PED显著相关(优势比(OR)2.06;P = 0.0090)。在MetS的各个组成部分中,只有超重和MetS范围内的高密度脂蛋白有类似的关联。按性别分层后,MetS与PED之间的关联仅在男性中持续存在(OR 3.16,P = 0.0094)。在接受胸痛和/或CVD风险评估的男性中,MetS与PED相关。在患有MetS的个体中识别PED可以提供简化的风险评估,有可能实现对危险因素的更早、更强化管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6ca/6615711/be547a7daf1b/DMSO-12-1035-g0001.jpg

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