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无症状老年人颈动脉内中膜厚度的决定因素:中国农村一项基于人群的横断面研究。

Determinants of carotid intima-media thickness in asymptomatic elders: a population-based cross-sectional study in rural China.

机构信息

Department of Cardiology, Tianjin Medical University General Hospital , Tianjin, China.

Department of Neurology, Tianjin Medical University General Hospital , Tianjin, China.

出版信息

Postgrad Med. 2020 Aug;132(6):544-550. doi: 10.1080/00325481.2020.1757266. Epub 2020 May 3.

Abstract

: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders. : Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT. : A total of 1039 individuals (47.9% men) were recruited. The mean CIMT value was 0.60 (SD: 0.09) mm. The mean CIMT was 24.07 (SEM: 6.52) µm greater in men than in women (P < 0.001) and 28.29 (SEM: 7.47) µm greater in patients with hypertension than in those without hypertension (P < 0.001). Moreover, the mean CIMT increased by 1.53 (SEM: 0.49) µm for each 1-year increase in age (P = 0.002). However, the mean CIMT decreased by 5.55 (SEM: 2.40) μm and 6.45 (SEM: 2.62) μm for every 1-mmol/L increase in triglyceride concentration and the high-density lipoprotein cholesterol: low-density lipoprotein cholesterol ratio, respectively (P < 0.05). However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036). : These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome.

摘要

目的

探讨老年人颈动脉内膜中层厚度(CIMT)的平均值及其与 CIMT 增加的相关决定因素。

方法

在中国一个低收入人群中,招募了无卒中和心血管疾病的年龄≥65 岁的居民。使用 B 型超声测量 CIMT。

结果

共招募了 1039 名个体(47.9%为男性)。平均 CIMT 值为 0.60(SD:0.09)mm。男性的平均 CIMT 比女性高 24.07(SEM:6.52)μm(P<0.001),高血压患者比无高血压患者高 28.29(SEM:7.47)μm(P<0.001)。此外,年龄每增加 1 岁,平均 CIMT 增加 1.53(SEM:0.49)μm(P=0.002)。然而,甘油三酯浓度每增加 1mmol/L,高密度脂蛋白胆固醇与低密度脂蛋白胆固醇比值每增加 1,平均 CIMT 分别降低 5.55(SEM:2.40)μm 和 6.45(SEM:2.62)μm(P<0.05)。然而,只有在没有代谢综合征的个体中,高甘油三酯水平与平均 CIMT 呈负相关(P=0.036)。

结论

这些发现表明,迫切需要通过管理高血压来延缓动脉粥样硬化进展和降低卒中负担,特别是对男性而言。此外,为了降低中国农村的卒中负担,在没有代谢综合征的老年患者中,降脂治疗应谨慎。

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