代谢综合征增加动脉硬化患病风险  

Metabolic syndrome associated with increased risk of arteriosclerosis

作　　者：陆骆[1,2,3] 张婕[1,2,3] 李勉[1,2,3] 任晨曦[1,2,3] 孙婉婉[1,2,3] 黄飞[1,2,3] 徐佰慧[1,2,3] 毕宇芳[1,2,3] 陈宇红[1,2,3] 宁光[1,2,3] 

机构地区：[1]上海市内分泌代谢病临床医学中心 [2]上海市内分泌代谢病研究所 [3]上海交通大学医学院附属瑞金医院内分泌代谢病科,上海200025

出　　处：《内科理论与实践》2012年第6期443-447,共5页Journal of Internal Medicine Concepts & Practice

基　　金：国家自然科学基金(项目编号:81170739);上海自然科学基金(项目编号:10ZR1426400)

摘　　要：目的：探讨代谢综合征各组分个数的递增会否增加动脉硬化的患病风险。方法：在上海市嘉定区40岁及以上居民中进行问卷调查、体格检查、血生化及肱一踝动脉脉搏波传导速度（baPWV）检测，对其中数据完整的2097人进行统计分析。baPWV值〉1753cm／s定义为动脉硬化：代谢综合征按美国国家胆固醇教育计划成人治疗组第3次报告（NCEP-ATPⅢ）标准诊断。采用多元线性回归和Logistic回归法分析代谢综合征及其组分与动脉硬化的相关性。结果：本研究人群中男、女性动脉硬化的患病率分别为23．64％和25．61％（P=0．1952）：代谢综合征患病率男性明显低于女性（31．28％比35．71％，P=0．0345）：将人群按代谢综合征组分个数的多少进行分组比较，发现随着代谢组分个数的递增。其动脉硬化患病率逐步增加，分别为2．69％、20．19％、29．81％、28．74％和37．16％，组间有显著差异（趋势P〈0．0001）：多元逐步回归筛选变量发现，baPWV与代谢综合征组分中的收缩压、空腹血糖和三酰甘油显著相关（8值分别为0．46、0．08和0．08，均P〈0．0001）；Logistic回归分析显示，在校正了多个混杂因素后，代谢组分每增加1项，其动脉硬化发生风险将为原来的1．46倍95％可信区间（CI）：1．29～1．67，P〈O．0001]；代谢综合征患者发生动脉硬化的风险是非代谢综合征患者的1．53倍（95％CI：1．13。2．08，P=0．0060）。结论：代谢综合征组分个数的递增会增加动脉硬化的患病风险。Objective To investigate whether metabolic syndrome and increase in number of metabolic syndrome components will increase the risk of arteriosclerosis in middle-aged and elderly Chinese population. Methods Two thousand five hundred and nineteen subjects aged 40 years or older from Jiading district, Shanghai, were recruited to undergo questionnaire interview, anthropometric measurements, biochemical evaluation, and brachial-ankle pulse wave velocity （baPWV） measurement. Statistical analysis was performed on 2 097 subjects （876 male and 1 221 female） with complete data. baPWV 〉 1 753 cm/s was defined as having arteriosclerosis. Metabolic syndrome was diagnosed according to the criteria of the third report of the national cholesterol education program （NCEP） expert panel on detection, evaluation, and treatment of high blood cholesterol in adults （adult treatment panel Ill ） （NCEP-ATPⅢ）. Multiple linear regression analysis and logistic regression analysis were performed to assess the correlation of metabolic syndrome and its components with arteriosclerosis. Results No statistically significant difference was seen between the prevalence of arteriosclerosis in male and female （ 23.64% and 25.61%, P = 0.195 2）. The prevalence of metabolic syndrome in male was significantly lower than that in female （ 31.28% and 35.71%, P=0.034 5）. With the increase in number of metabolic syndrome components from one to five, the prevalence of arteriosclerosis increased from 2.69%, 20.19%, 29.81%, 28.74% to 37.16% （ trend P 〈 0.000 1）. In multiple stepwise linear regression analysis, systolic blood pressure （SBP）, fasting plasma glucose （FPG） and triglycerides （TG） showed a close relationship with baPWV （ values were 0.46, 0.08 and 0.08, respectively; all P 〈0.000 1）. Logistic regression analysis showed that, after adjusting the confounding factors, each increase in number of metabolic syndrome components by one had 1.46-fold increase of risk of arteriosclerosis （95%CI： 1.29-1.

关 键 词：代谢综合征 动脉硬化 肱-踝动脉脉搏波传导速度 

分 类 号：R589[医药卫生—内分泌]