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[墨西哥人群中的代谢综合征、脂蛋白(a)与亚临床动脉粥样硬化]

[Metabolic syndrome, lipoprotein(a) and subclinical atherosclerosis in Mexican population].

作者信息

Cardoso-Saldaña Guillermo C, González-Salazar María Del C, Posadas-Sánchez Rosalinda, Vargas-Alarcón Gilberto

机构信息

Departamento de Endocrinología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

Departamento de Biología Molecular. Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.

出版信息

Arch Cardiol Mex. 2021 Jun 1;91(3):307-314. doi: 10.24875/ACM.20000276.

Abstract

OBJECTIVE

To assess the relationship of metabolic syndrome (MetS) and Lp(a) with subclinical atherosclerosis (CAC) in Mexican adults.

METHOD

Clinical, biochemical and tomographic data of visceral, subcutaneous, hepatic abdominal fat and CAC were evaluated in 953 women and men. Lp(a) was determined by nephelometry and MetS was diagnosed according to ATP III criteria. Multivariate logistic regression analysis was performed to determine the independent association of these variables with CAC.

RESULTS

Age, weight, body mass index, systolic and diastolic blood pressure, volumes of visceral, subcutaneous and hepatic abdominal fat, lipids, glucose, insulin and HOMA-RI were significantly higher in subjects with MetS. The median Lp(a) was lower in subjects with MetS compared to subjects without MetS (3.7 [IR: 2.3-9.2 vs. 5.9 [IR: 2.5-13.1) mg/dL; p < 0.01). The number of components and the MetS were inversely associated with the elevated Lp(a) (> 30 mg / dL). The presence of MetS was associated with a CAC risk >0 (OR: 2.19, [95% CI (1.64-2.94)]; p < 0.001), independently of elevated Lp(a). The components of MetS that were independently associated with the presence of CAC > 0 UA were glycaemia > 100 mg/dL (OR 2.42, [95% CI (1.7-3.4)]; p < 0.0001) and high blood pressure (OR 2.14 [95% CI (1.5-3.1)]; p < 0.0001).

CONCLUSIONS

In Mexican population there is an inverse association between Lp(a) levels and MetS. The MetS and its components were associated with subclinical atherosclerosis. The high prevalence of obesity, diabetes, high blood pressure high triglycerides and low HDL-C, characteristics of Mexican population could explain the differences with other populations.

摘要

目的

评估墨西哥成年人中代谢综合征(MetS)和脂蛋白(a)[Lp(a)]与亚临床动脉粥样硬化(CAC)之间的关系。

方法

对953名女性和男性的临床、生化以及内脏、皮下、肝脏腹部脂肪和CAC的断层扫描数据进行评估。通过散射比浊法测定Lp(a),并根据ATP III标准诊断MetS。进行多变量逻辑回归分析以确定这些变量与CAC的独立关联。

结果

MetS患者的年龄、体重、体重指数、收缩压和舒张压、内脏、皮下和肝脏腹部脂肪体积、血脂、血糖、胰岛素和胰岛素抵抗指数(HOMA-RI)显著更高。与无MetS的受试者相比,MetS患者的Lp(a)中位数更低(3.7[四分位间距(IR):2.3 - 9.2]与5.9[IR:2.5 - 13.1]mg/dL;p < 0.01)。MetS的组分数量和MetS与升高的Lp(a)(> 30 mg / dL)呈负相关。MetS的存在与CAC风险>0相关(比值比:2.19,[95%置信区间(CI)(1.64 - 2.94)];p < 0.001),与升高的Lp(a)无关。与CAC > 0 UA存在独立相关的MetS组分是血糖> 100 mg/dL(比值比2.42,[95% CI(1.7 - 3.4)];p < 0.0001)和高血压(比值比2.14 [95% CI(1.5 - 3.1)];p < 0.0001)。

结论

在墨西哥人群中,Lp(a)水平与MetS之间存在负相关。MetS及其组分与亚临床动脉粥样硬化相关。肥胖、糖尿病、高血压、高甘油三酯和低高密度脂蛋白胆固醇(HDL-C)的高患病率是墨西哥人群的特征,这可能解释了与其他人群的差异。

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