皮肤自发荧光与颈动脉粥样硬化斑块的关系研究  

Relationship between Skin Autofluorescence Value and Carotid Artery Atherosclerotic Plaque Disease

作　　者：刘林[1] 张健[1] 刘薇[1] 黄有媛[1] 贾佳[2] 王淑玉[3] 张洋[4] 王贻坤[4] 东黎光[5] 王安平[6] 司莫奎 高莹[1] 张俊清[1] LIU Lin;ZHANG Jian;LIU Wei;HUANG Youyuan;JIA Jia;WANG Shuyu;ZHANG Yang;WANG Yikun;DONG Liguang;WANG Anping;SI Mokui;GAO Ying;ZHANG Junqing(Endocrinology Department,Peking University First Hospital,Beijing 100034,China;Cardiology Department,Peking University First Hospital,Beijing 100034,China;Chinese Hypertension League,Beijing 100041,China;Institute of Applied Technology,Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei 230088,China;Gucheng Community Health Center,Peking University Shougang Hospital,Beijing 100041,China;Endocrinology Department,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]北京大学第一医院内分泌科,北京市100034 [2]北京大学第一医院心内科,北京市100034 [3]中国高血压联盟研究所,北京市100041 [4]中国科学院合肥物质科学研究院应用技术研究所,安徽省合肥市230088 [5]北京大学首钢医院古城社区服务中心,北京市100041 [6]解放军总医院内分泌科,北京市100039

出　　处：《中国全科医学》2021年第4期442-446,共5页Chinese General Practice

基　　金：北京市科技计划课题(D171100002817001);中国科学院科技服务网络计划(STS计划)(KFJ-STS-ZDTP-063);中国科学院国际合作局对外合作重点项目(116134KYSB20170018)。

摘　　要：背景颈动脉粥样硬化斑块是心脑血管疾病重要的危险因素,多用超声评价,但超声检查对设备、人员、经费要求较高。皮肤自发荧光(SAF)能够独立预测心脑血管事件发生及死亡等,操作简便、迅速、无创,因此探讨SAF与颈动脉粥样硬化斑块的关系对于颈动脉病变的预测有一定意义。目的探讨在我国社区人群中SAF与颈动脉粥样硬化斑块病变的相关性。方法2018年9-12月对北京某社区年龄>40岁的6055例居民进行横断面调查研究,对所有受访者进行SAF检测、临床病史采集、体格检查、血液学检测及颈动脉B超检查。根据B超结果是否存在颈动脉粥样硬化斑块分为颈动脉粥样硬化斑块组和无颈动脉粥样硬化斑块组。以颈动脉粥样硬化斑块为因变量,以标准化性别、年龄、BMI、吸烟、糖尿病、高血压、脂代谢紊乱、高尿酸血症、慢性肾功能不全等传统心脑血管病变危险因素及SAF为自变量进行Logistic回归分析,探讨SAF对颈动脉粥样硬化斑块的影响。结果6055例调查对象B超提示存在颈动脉粥样硬化斑块者2953例,无颈动脉粥样硬化斑块者3102例。颈动脉粥样硬化斑块组SAF测量值为77.2(70.8,85.1)AU,明显高于无颈动脉粥样硬化斑块组SAF测量值73.4(68.0,80.1)AU(P<0.001)。Logistic回归分析结果显示,SAF是颈动脉粥样硬化斑块的影响因素〔OR=1.006,95%CI(1.000,1.012),P=0.043〕。以SAF值的第25、50、75百分位值69.2、75.1、82.4 AU为界,分为SAF低、中、高、明显升高4组,SAF明显升高组颈动脉粥样硬化斑块风险是SAF低值组的1.200倍〔OR=1.200,95%CI(1.012,1.423),P=0.036〕。亚组分析显示,校正传统心血管危险因素后,年龄<60岁人群中SAF明显升高组颈动脉粥样硬化斑块风险是SAF低值组的1.751倍〔OR=1.751,95%CI(1.270,2.415),P=0.001〕;吸烟人群中SAF明显升高组颈动脉粥样硬化斑块风险是SAF低值组的1.903倍〔OR=1.903,95%CI(1.297,2.792),P=0.001�Background Carotid atherosclerotic plaque is an important risk factor for cardiovascular and cerebrovascular diseases.Ultrasound is often used to evaluate carotid atherosclerotic plaque,but ultrasonic examination has relative high requirements on equipment,operator's ability and fund.Skin autofluorescence(SAF),a simple,rapid and noninvasive method,has a predictive value for cerebrovascular events and death.So we discussed the relationship between SAF value and carotid atherosclerotic plaque.Objective To discuss the relationship between SAF value and carotid atherosclerotic plaque in community-dwelling Chinese populations.Methods 6055 eligible residents aged over 40 in a Beijing community were invited to conduct a cross-sectional study from September 2018 to December 2018.SAF test,clinical history collection,physical examination,hematology test and carotid B-ultrasonography examination were performed in all subjects.According to the results of B-ultrasonography,the subjects were divided into carotid lesion group and non-carotid lesion group.With carotid lesion as dependent variable,and traditional risk factors of cardiovascular and cerebrovascular diseases such as standardized gender,age,BMI,smoking,diabetes,hypertension,dyslipidemia,hyperuricemia,chronic renal insufficiency and SAF as independent variables,Logistic regression analysis was performed to explore the relationship between SAF value and carotid atherosclerotic plaque.Results Carotid lesion group(n=2953)had much higher SAF value than non-carotid lesion group(n=3102)〔77.2(70.8,85.1)AU vs 73.4(68.0,80.1)AU〕(P<0.001).Binary Logistic regression analysis showed that SAF value was associated with the risk of carotid artery disease〔OR=1.006,95%CI(1.000,1.012),P=0.043〕.Analysis of subgroups stratified by quartiles of SAF value〔low(less than 69.2 AU),intermediate(greater than 69.2 but less than 75.1 AU),high(greater than 75.1 but less than 82.4 AU),very high(greater than 82.4 AU)〕revealed that the risk of carotid artery lesion in very high SAF subgro

关 键 词：晚期糖基化终末产物 皮肤自发荧光 颈动脉粥样硬化斑块 糖尿病 年龄增长 

分 类 号：R543[医药卫生—心血管疾病] R443[医药卫生—内科学]