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评估亚临床颈动脉粥样硬化患者的血液流变学特征,根据心血管危险因素的数量和不同程度的胰岛素抵抗进行分组。

An assessment of the hemorheological profile in patients with subclinical carotid atherosclerosis divided in relation to the number of cardiovascular risk factors and different degrees of insulin resistance.

机构信息

Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Universitá Degli Studi Di Palermo, Palermo, Italy.

Fondazione Istituto "G. Giglio", Cefalù, Italy.

出版信息

Clin Hemorheol Microcirc. 2021;78(4):417-428. doi: 10.3233/CH-211105.

DOI:10.3233/CH-211105
PMID:33843665
Abstract

We present a cohort of 100 subjects [43 men and 57 women; median age 66.00(25)] who were tested using carotid ultrasound to identify subclinical carotid atherosclerosis (SCA). We have evaluated the behaviour of whole blood viscosity (WBV) at high (450 s-1) and low (0.51 s-1) shear rates, plasma viscosity (450-1), hematocrit and mean erythrocyte aggregation. When compared to normal control subjects, using the Mann-Whitney test, we observed in SCA patients a significant increase in WBV only. The results were substantial after having divided the SCA subjects according to the cardiovascular risk factors (CRFs) and the degree of insulin resistance; the research was performed using two surrogate indexes such as TG/HDL-C and TyG. With the division carried out according to CRFs, employing the Kruskal-Wallis test, results show a significant increase in WBV (at high and low shear rates), in plasma viscosity, in erythrocyte aggregation and plasma fibrinogen level. Whereas by dividing them into the median of TG/HDL-C and TyG, we noticed a significant increase in WBV (at high and low shear rates) and in erythrocyte aggregation in the two groups with high TG/HDL-C ratio and with high TyG; having found an increased level of plasma fibrinogen in the latter. The data underlines the role of the main hemorheologic aspects in subclinical carotid atherosclerosis being closely correlated to the CRFs and different degrees of insulin resistance.

摘要

我们报告了一项 100 例受试者的队列研究[43 名男性和 57 名女性;中位数年龄 66.00(25)],这些受试者接受了颈动脉超声检查以识别亚临床颈动脉粥样硬化(SCA)。我们评估了全血粘度(WBV)在高剪切率(450 s-1)和低剪切率(0.51 s-1)、血浆粘度(450-1)、血细胞比容和平均红细胞聚集率的变化。与正常对照组相比,我们使用曼-惠特尼检验观察到 SCA 患者仅在高剪切率下 WBV 显著增加。当根据心血管危险因素(CRFs)和胰岛素抵抗程度将 SCA 患者分为两组后,结果更加显著;该研究使用 TG/HDL-C 和 TyG 这两个替代指标进行。根据 CRFs 进行分组后,使用 Kruskal-Wallis 检验结果显示,WBV(高剪切率和低剪切率)、血浆粘度、红细胞聚集和血浆纤维蛋白原水平均显著增加。而根据 TG/HDL-C 和 TyG 的中位数将他们分组后,我们注意到在 TG/HDL-C 比值高和 TyG 高的两组中,WBV(高剪切率和低剪切率)和红细胞聚集显著增加,而在后一组中发现血浆纤维蛋白原水平升高。这些数据强调了主要血液流变学参数在亚临床颈动脉粥样硬化中的作用,与 CRFs 和不同程度的胰岛素抵抗密切相关。

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