较高的身体质量指数与靶器官损害前的动脉僵硬度增加有关：一项横断面队列研究。

Higher Body Mass Index is associated with increased arterial stiffness prior to target organ damage: a cross-sectional cohort study.

机构信息

Department of Dialysis, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000, Maribor, Slovenia.

Department of Nephrology, Clinic for Internal Medicine, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000, Maribor, Slovenia.

出版信息

BMC Cardiovasc Disord. 2023 Sep 14;23(1):460. doi: 10.1186/s12872-023-03503-5.

DOI:10.1186/s12872-023-03503-5

PMID:37710152

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10503091/

Abstract

BACKGROUND

Obesity is associated with several neurohumoral changes that play an essential role in organ damage. Increased arterial stiffness causes functional vessel wall changes and can therefore lead to accelerated target organ damage as well. Whether obesity causes an independent increase in central arterial stiffness is, however, not yet fully known.

METHODS

One hundred thirty-three patients (63.2% male) were included. Body Mass Index (BMI) was defined as body weight in kilograms, divided by the square of body height in meters. Chronic Kidney Disease Epidemiology Collaboration creatinine 2009 equation was used to estimate the glomerular filtration rate (eGFR). Non-invasive applanation tonometry was used for arterial stiffness measurements (Sphygmocor Atcor Medical, Sydney, Australia). All patients underwent coronarography.

RESULTS

The mean age of our patients was 65.0 ± 9.2 years. Their mean BMI was 28.5 ± 4.4 kg/m, eGFR 75.5 ± 17.2 ml/min/1.73 m and ankle-brachial index (ABI) 1.0 ± 0.1. Their arterial stiffness measurements showed mean carotid-femoral pulse wave velocity (cfPWV) 10.3 ± 2.7 m/s, subendocardial viability ratio (SEVR) 164.4 ± 35.0%, and pulse pressure (PP) 47.8 ± 14.5 mmHg. Spearman's correlation test revealed a statistically significant correlation between BMI and SEVR (r = -0.193; p = 0.026), BMI and cfPWV (r = 0.417; p < 0.001) and between BMI and PP (r = 0.227; p = 0.009). Multiple regression analysis confirmed an independent connection between BMI and cfPWV (B = 0.303; p < 0.001) and between BMI and SEVR (B = -0.186; p = 0.040). There was no association between BMI and kidney function, ABI, or coronary artery disease.

CONCLUSION

Increased BMI is independently associated with augmented central arterial stiffness and reduced subendocardial perfusion but not with coronary artery disease, kidney function, or ABI.

摘要

背景

肥胖与多种神经体液变化有关，这些变化在器官损伤中起着重要作用。动脉僵硬度的增加导致功能性血管壁变化，因此也会导致靶器官损伤加速。然而，肥胖是否会导致中央动脉僵硬度的独立增加尚不完全清楚。

方法

纳入 133 名患者（63.2%为男性）。体重指数（BMI）定义为体重（千克）除以身高（米）的平方。慢性肾脏病流行病学合作组 2009 年肌酐方程用于估计肾小球滤过率（eGFR）。使用无创平板张力测量仪（Sphygmocor Atcor Medical，悉尼，澳大利亚）进行动脉僵硬度测量。所有患者均接受冠状动脉造影。

结果

我们患者的平均年龄为 65.0±9.2 岁。他们的平均 BMI 为 28.5±4.4kg/m，eGFR 为 75.5±17.2ml/min/1.73m，踝臂指数（ABI）为 1.0±0.1。他们的动脉僵硬度测量显示颈动脉-股动脉脉搏波速度（cfPWV）平均为 10.3±2.7m/s，心内膜下存活比（SEVR）为 164.4±35.0%，脉压（PP）为 47.8±14.5mmHg。Spearman 相关检验显示 BMI 与 SEVR（r=-0.193；p=0.026）、BMI 与 cfPWV（r=0.417；p<0.001）和 BMI 与 PP（r=0.227；p=0.009）之间存在统计学显著相关性。多元回归分析证实 BMI 与 cfPWV（B=0.303；p<0.001）和 BMI 与 SEVR（B=-0.186；p=0.040）之间存在独立联系。BMI 与肾功能、ABI 或冠状动脉疾病之间无相关性。