内脏肥胖与透析患者动脉粥样硬化的相关性  

Relationship between visceral obesity and atherosclerosis in hemodialysis patients

作　　者：何平红[1] 闵亚丽[2] 周朝敏[1] 佟小雅 林鑫[1] 李倩[1] 查艳[1] He Pinghong ,Min Yali, Zhou Chaomin, Tong Xiaoya, Lin Xin, Li Qian, Zha Yan(Renal Division, Department of Medicine, Guizhou Provincial People＇s Hospital, Guiyang 550002, China; Department of Nephrology, First People＇s Hospital of Guiyang, Guiyang 550002, China)

机构地区：[1]贵州省人民医院肾内科,贵阳550002 [2]贵阳市第一人民医院肾内科

出　　处：《中华医学杂志》2018年第42期3411-3414,共4页National Medical Journal of China

基　　金：贵州省人民医院青年基金（GZSYQN[2016]11）;贵州省科技厅-贵州省人民医院联合基金项目（黔科合LH字[2014]7001号）

摘　　要：目的探讨内脏肥胖替代性指标高三酰甘油血症腰围（HW）表型、内脏肥胖指数（VAI）、脂肪堆积产物指数（LAP）与透析患者动脉粥样硬化的相关性。 方法多中心横断面研究。纳入2016年7月—2017年9月贵州省11家血液透析中心961例维持性血液透析（MHD）患者，测量身高、干体重、腰围，查阅病历收集患者三酰甘油、高密度脂蛋白、低密度脂蛋白等指标。采用Pearson相关性分析探讨HW表型、VAI、LAP与透析患者血浆致动脉粥样硬化指数（AIP）的相关性，应用多重线性回归分析探讨AIP的相关因素。结果共961例MHD患者，男585例、女376例，年龄18～90（56.08±15.42）岁。Pearson相关分析结果显示，VAI（男性：r＝0.82，女性：r＝0.84）、LAP（男性：r＝0.73，女性：r＝0.74）、有HW表型（男性：r＝0.62，女性：r＝0.63）与AIP呈正相关（均P〈0.001）。多重线性回归分析结果显示，校正年龄、高血压、糖尿病、吸烟及体质指数（BMI）等传统动脉粥样硬化相关因素后，VAI（男性：β＝0.77，女性β＝0.82）、LAP（男性：β＝0.73，女性，β＝0.73）是AIP的独立相关因素（均P〈0.001）。结论VAI、LAP独立于BMI及年龄、吸烟等传统动脉粥样硬化危险因素与MHD患者AIP呈正相关性。ObjectiveTo evaluate the relationship between surrogate markers of visceral obesity[hypertriglyceridemic waist （HW） phenotype, visceral adiposity index （VAL）, lipid accumulation product （LAP）]and atherosclerosis in hemodialysis patients.MethodsA multi-center cross-sectional study was carried out. A total of 961 maintenance hemodialysis （MHD） patients from 11 hemodialysis centers of Guizhou province between July 2016 and September 2017 were enrolled in the study. Anthropometric measures were performed in all subjects. Laboratory parameters including triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein-cholesterol were extracted from the medical records by researchers. Pearson correlation analysis was used to investigate the correlation between HW phenotype, VAI, LAP and plasma atherosclerotic index （AIP）. Multivariate linear regression analysis was used to evaluate factors affecting AIP.ResultsTotally, 585 men and 376 women aged 18-90 years, with a mean age of （56.08±15.42） years were recruited in the study. Pearson correlation analysis showed that VAI （men： r=0.82, women： r=0.84）, LAP （men： r=0.73, women： r=0.74） and having HW phenotype （men： r=0.62, women： r=0.63） correlated positively with AIP （all P〈0.001）. Multivariate linear regression analysis showed that VAI （men： β=0.77, women： β=0.82） and LAP （men： β=0.73, women： β=0.73） were independent associated factors of AIP after adjustment of BMI, age, smoking and history of diabetes and hypertension （all P〈0.001）.ConclusionsSurrogate markers of visceral obesity such as having HW phenotype, VAI, LAP correlated positively with AIP. VAI, LAP has positive impacts on AIP independent of BMI, age, smoking and other traditional atherosclerosis risk factors.

关 键 词：血液透析 动脉粥样硬化 内脏肥胖 脂肪堆积产物指数 

分 类 号：R692.5[医药卫生—泌尿科学]