腹型肥胖测量指标与冠状动脉粥样硬化病变的关系  

Relationship among indexes of central obesity and coronary atherosclerosis

作　　者：陈寒萼[1] 范例[1] 吴士尧[1] 王长谦[1] 陈启稚[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院心内科,上海市200011

出　　处：《心血管康复医学杂志》2011年第5期412-416,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：通过分析腰围、腰臀比、腰身指数三种腹型肥胖测量指标与冠状动脉Gensini积分之间的相关性来探讨哪种指标与冠脉病变关系更密切。方法：选择进行冠脉造影的患者162名，按冠脉Gensini积分对所选病例进行四分位分组。对各组分别进行基本特征及生化指标对照分析，对各腹型肥胖指标与冠脉Gensini积分的关系进行多元Logistic回归分析，以评估各指标与心脑血管病危险的相关性。结果：（1）与Gensini积分最低分位组相比，积分最高分位组的腰围[（83．41±8．22）cm比（92．20±8．49）cm]、腰臀比[（0.90±0．07）比（0．97±0．06）]、腰身指数[（0．52±0．06）比（0．56±0．06）]、人体质量指数[（23．48±2．59）kg／m^2比（25．94±3．26）kg／m^2]均显著升高，P均〈0.01，吸烟比例、甘油三酯、总胆固醇、空腹血糖及尿酸水平均显著升高（P〈0．05～〈0．01），HDL显著降低（P〈0．05）；（2）简单直线相关分析显示，腰围、腰臀比与Gensini积分呈显著正相关（r=0．22，P〈0．01；r=0．27，P〈0．01）。多元直线回归分析显示，腰臀比与Gensini积分呈明显正相关（标准偏回归系数-1．31，P=0．005），而腰围、腰身指数与Gensini积分无显著相关性；（3）调整年龄、性别、吸烟、饮酒、空腹血糖、甘油三酯、总胆固醇、尿酸等干扰因素后，多元Logistic回归分析显示腰臀比与心血管事件危险仍具有显著关联[Or=1．13（1．04—1．23），P=0．005]。结论：与腰围、腰身指数相比，腰臀比与冠状动脉粥样硬化及心脑血管病事件危险的关系最密切。Objective： To study the relationship among three indexes of central obesity [waist circumference （WC）, waist hip ratio （WHR） and waist-height ratio （WHtR）] and coronary Gensini score. Methods： A total of 162 patients undergoing coronary angiography were enrolled and divided into four groups according to interquartile of coronary Gensini score. Linear correlation analysis was used to evaluate the relationship among indexes of central obesity and coronary Gensini score. Multiple Logistic regression analysis was used to evaluate relationship among indexes of central obesity and risk of major adverse eardiovascular-cerebralevents （MACCE）. Results： （1） Compared with lowest Gensini score group, in highest score group, there were significant increase in WC [ （83.41±8.22） cm vs. （92.20±8.49） cm], WHR [ （0.90±0.07） vs. （0.97±0.06）], WHtR [（0.52±0.06） vs. （0.56±0.06）] and body mass index （BMI） [ （23.48±2.59） kg/m^2 vs. （25.94±3.26） kg/m^2], P〈0.01 all; and there were also significant increase in ratio of smokers, levels of triglyceride, total cholesterol, fasting plasma glucose and uric acid, P〈0.05-〈 0.01; levels of high density lipoprotein significantly decreased in highest score group; （2） Linear correlation analysis show that WCand WHR were positively correlated with Gensini scores （r=0.22, P〈0.01; r=0.27, P〈0.01）. Multiple linear regression analysis indicated that WHR was positively correlated with Gensini scores （β= 1.31, P= 0. 005）, but WC and WHtR were no significant correlation with Gensini scores; （3） Multiple logistic regression analysis showed that WHR was significantly eorrdated with risk of MACCE [OR= 1.13 （ 1.04- 1.2Z）, P= 0.005]. Couclusion： Compared with WC and WHtR, WHR show more closer relation with coronary atheroselerosis and MACE.

关 键 词：肥胖症 冠状动脉疾病 心血管疾病 

分 类 号：R541.409[医药卫生—心血管疾病]