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肥胖患者循环中高敏心肌肌钙蛋白 t 水平升高与心脏重构。

Elevated circulating high-sensitivity cardiac troponin t and cardiac remodeling in obesity.

机构信息

Department of General Practice, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China.

Department of Health Management Center, Zhongshan Hospital, Shanghai Medical College of Fudan University, Shanghai, China.

出版信息

BMC Cardiovasc Disord. 2021 Dec 28;21(1):620. doi: 10.1186/s12872-021-02445-0.

Abstract

BACKGROUND

It is well established that body mass index (BMI) and troponins are independently associated. However, whether the obesity could cause myocardial injury independent of coronary heart disease (CHD) remains unclear. This study focuses on the relationship between BMI and troponins, and whether this relationship is being attenuated when CHD is accounted for.

METHODS

In populations without acute ischemic events, 383 patients with coronary artery stenosis less than 75% were included, that is, people who have not yet reached the indications for coronary intervention, and of them 70 patients being obese according to BMI ≥ 28 kg/m. Continuous variables were represented as mean ± SD or median(inter quartile range[IQR]). Chi-square test was adopted for categorical data. Correlations between variables were evaluated by Spearman analysis, multiple regression or logistic regression.

RESULTS

The circulating hs-cTnT level was higher in the obese group [8(6,11) ng/L vs. 6(4,9) ng/L; p < 0.001). In subgroup analysis based on the presence or absence of coronary heart disease(CHD), the adjusted β(95%CI) for circulating hs-cTnT exhibited a proportional relationship with BMI when the non-obesity were defined as the reference[β; 2.22(95%CI, 0.73 to 3.71) in non-CHD, 5.58(95%CI, 0.70 to 10.46) in CHD, p < 0.05]. Additionally, the degree of coronary stenosis has shown a positive correlation with circulating hs-cTnT (rho = 0.1162; p < 0.05).

CONCLUSION

When CHD is taken into account, obesity is independently associated to the elevation of circulating hs-cTnT, a biomarker of myocardial injury, potentially indicating the impact of obesity on non-ischemic subclinical myocardial injury.

摘要

背景

体重指数(BMI)和肌钙蛋白独立相关,这一点已得到充分证实。然而,肥胖是否可以独立于冠心病(CHD)引起心肌损伤仍不清楚。本研究关注 BMI 与肌钙蛋白之间的关系,以及在考虑 CHD 时这种关系是否会减弱。

方法

在没有急性缺血事件的人群中,纳入 383 名冠状动脉狭窄小于 75%的患者,即尚未达到冠状动脉介入治疗指征的人群,其中 70 名患者根据 BMI≥28kg/m2 被诊断为肥胖。连续变量用均数±标准差或中位数(四分位间距[IQR])表示。分类数据采用卡方检验。用 Spearman 分析、多元回归或逻辑回归评估变量之间的相关性。

结果

肥胖组循环高敏肌钙蛋白 T 水平较高[8(6,11)ng/L 比 6(4,9)ng/L;p<0.001]。在基于是否存在冠心病(CHD)的亚组分析中,当非肥胖定义为参考时,循环高敏肌钙蛋白 T 的调整β(95%CI)与 BMI 呈比例关系[非 CHD 组为 2.22(95%CI,0.73 至 3.71),CHD 组为 5.58(95%CI,0.70 至 10.46),p<0.05]。此外,冠状动脉狭窄程度与循环高敏肌钙蛋白 T 呈正相关(rho=0.1162;p<0.05)。

结论

当考虑 CHD 时,肥胖与循环高敏肌钙蛋白 T 的升高独立相关,高敏肌钙蛋白 T 是心肌损伤的生物标志物,可能表明肥胖对非缺血性亚临床心肌损伤的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9a1/8714432/2e29d540598b/12872_2021_2445_Fig1_HTML.jpg

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