基于定量CT探讨内脏脂肪面积与颈动脉斑块相关性的研究  

A study of correlation between visceral fat area and carotid artery plaques based on quantitative CT

作　　者：王琳[1] 秦迁[1] 陈静锋 丁素英[1] WANG Lin;QIN Qian;CHEN Jing-feng;DING Su-ying(Health Management Center,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院健康管理中心,河南郑州450052

出　　处：《现代预防医学》2023年第6期1139-1145,共7页Modern Preventive Medicine

基　　金：国家自然科学基金(72101236);中国博士后科学基金(2022M722900);河南省重点研发与推广专项(科技攻关)支持项目(222102310226);河南省高等学校重点科研项目计划(21A320035);河南省医学科技攻关计划联合共建项目(LHGJ20200279,LHGJ20200311);河南省青年人才托举工程项目(2021HYTP052)。

摘　　要：目的基于定量CT(Quantitative Computed Tomography,QCT)探讨内脏脂肪面积(Visceral Fat Area,VFA)与颈动脉斑块相关性的研究。方法回顾性选取我院体检中心2017年1月至2019年12月行QCT、颈部动脉超声检查的体检人群为研究对象,采集一般资料、生理、生化等信息。将研究对象的VFA按四分位数法进行分组,采用logistic回归(向后逐步回归法)分析影响颈动脉斑块的危险因素,分析VFA与颈动脉斑块的相关性。结果(1)共纳入研究对象2645例,检出颈动脉斑块者(斑块组)1230例(46.5%),其中男性685例(51.66%),女性545例(41.32%)。与无颈动脉斑块者(对照组)相比,斑块组的年龄、腰围、体重指数、收缩压、舒张压、总胆固醇、甘油三脂、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白、尿酸均较高(P<0.05)。(2)单因素logistic回归分析显示:年龄≥60岁、男性、腰围、收缩压、舒张压、体重指数、尿酸、总胆固醇、甘油三酯、低密度脂蛋白、空腹血糖、糖化血红蛋白、VFA是颈部动脉斑块的危险因素(各OR>1,各P<0.05)。(3)多因素logistic回归分析显示:不论调整何种混杂因素,VFA均是颈动脉斑块的危险因素(各OR>1,各P<0.05)。在模型4中,调整性别、年龄、腰围、体重指数、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、糖化血红蛋白、尿酸等因素,Q3组和Q4组发生颈动脉斑块的风险分别是Q1组的1.73倍(95%CI=1.25~2.39)和1.71倍(95%CI=1.15~2.55);在男性中,Q3组和Q4组发生颈动脉斑块的风险分别是Q1组的1.67倍(95%CI=1.17~2.40)和1.79倍(95%CI=1.12~2.86);女性VFA的四分位数分组数据中,未发现和男性类似的趋势(P>0.05)。结论男性VFA水平与颈动脉斑块发生风险正相关,科学防控VFA可能是预防颈动脉斑块的有效措施。Objective To investigate the correlation between visceral fat area(VFA)and carotid artery plaques based on quantitative computed tomography(QCT).Methods This study was a retrospective study.The participants who underwent QCT and ultrasound examination of carotid artery in the health management center of our hospital were recruited from January 2017 to December 2019.Baseline data such as height,weight and blood pressure were collected.Participants were distributed according to the VFA values which were analyzed by quartile.The risk factors of correlation between VFA and carotid plaques were analyzed by Logistic regression model(backward stepwise regression).Results①A total of 2645 subjects were included in this study,including 1326 males(50.1%)and 1319 females(49.9%).Carotid plaque was detected in1230 cases(46.5%),including 685 men(51.66%)and 545 women(41.32%).Carotid plaque were found to have a higher incidence in individuals with age≥60 years old,a larger waist,a higher body mass index(BMI),a higher systolic blood pressure(SBP),a higher diastolic blood pressure(DBP),a higher total cholesterol(T-CHO)value,a higher triglyceride(TG)value,a higher low density lipoprotein cholesterol(LDL)value,a higher fasting blood glucose(FPG)value,a higher hemoglobin A1c(HbA1c)value,and a higher uric acid(UA)value(P<0.05).②According to the univariate Logistic regression analysis,the risk factors of carotid plaque included age≥60 years old,male,waist,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),uric acid(UA)value,total cholesterol(T-CHO)value,triglyceride(TG)value,low density lipoprotein cholesterol(LDL)value,fasting plasma glucose(FPG)value,hemoglobin A1c(HbA1c)value,and visceral fat area(VFA)value.③What’s more,multivariate Logistic regression was used to analyze the correlation between different VFA and carotid plaque,results indicated that VFA was a risk factor for carotid plaque regardless of adjustment for any confounding factor(OR>1,P<0.05).In model 4,when adjusting age,gender

关 键 词：内脏脂肪面积 颈动脉斑块 定量CT 危险因素 

分 类 号：R543.4[医药卫生—心血管疾病]