成人先天性心脏病患者代谢综合征的患病率及危险因素分析  

Prevalence and risk factors of metabolic syndrome in adults with congenital heart disease

作　　者：胡娟舟 张迎红[1] 张文[2] 王艳 胡柳 刘佳[1] 黄静 彭盼 HU Juanzhou;ZHANG Yinghong;ZHANG Wen;WANG Yan;HU Liu;LIU Jia;HUANG Jing;PENG Pan(Medical College,Wuhan University of Science and Technology,Wuhan,430065,China;Department of Cardiology,Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology;PLA Central War Zone General Hospital;Department of Cardiology,Wuhan Puren Hospital)

机构地区：[1]武汉科技大学医学院,武汉430065 [2]武汉科技大学附属武汉亚洲心脏病医院心外科 [3]中国人民解放军中部战区总医院 [4]武汉市普仁医院心外科

出　　处：《临床心血管病杂志》2023年第6期432-437,共6页Journal of Clinical Cardiology

基　　金：湖北省健康委员会联合基金项目(No:WJ2019H345)。

摘　　要：目的:调查我国成人先天性心脏病(adult congenital heart disease, ACHD)患者发生代谢综合征(metabolic syndrome, MS)的现状及其影响因素,为制订相关防治策略提供有力的理论依据。方法:选取2020年1月—2022年1月就诊于武汉科技大学附属武汉亚洲心脏病医院的1 833例ACHD患者作为研究对象,根据国际糖尿病联盟(IDF)MS诊断标准将患者分为MS组和非MS组,比较不同种类、性别、年龄患者MS患病情况,采用单因素分析和多因素logistic回归分析ACHD患者发生MS的危险因素。结果:1 833例ACHD患者中共265例发生MS,MS的总体患病率为14.5%,轻度和中重度ACHD患者患病率分别为15.6%和11.8%,男性患病率为17.8%,女性患病率12.9%,两者随着年龄增长患病率逐渐增加,老年阶段患病率最高,为27.4%。MS中单一指标异常率最高,其中高密度脂蛋白胆固醇降低和中心性肥胖患病率较高,分别为33.2%、31.5%。多因素logistic回归分析结果显示男性、体重指数增高、腰围增加、收缩压升高、空腹血糖升高、甘油三酯升高、肾小球滤过率下降、天门冬氨酸转移酶增高以及肺动脉高压是ACHD患者发生MS的独立危险因素(P<0.05)。结论:MS在ACHD患者中的患病率较普通人群高,应加强ACHD患者MS的筛查和预防性健康宣教。Objective: To investigate the current situation and influencing factors of metabolic syndrome(MS) in adult patients with congenital heart disease(ACHD) in China, and to provide a strong theoretical basis for formulating relevant prevention and treatment strategies. Methods: A total of 1833 ACHD patients who visited Wuhan Asia Heart Hospital Affiliated to Wuhan University of Science and Technology from January 2020 to January 2022 were selected as the study subjects. The patients were divided into MS group and non-MS group according to the International Diabetes Federation(IDF) MS diagnostic criteria. The prevalence of MS in patients with different types, genders and ages was compared. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of MS in ACHD patients. Results: A total of 265 of 1833 ACHD patients developed MS. The overall prevalence of MS was 14.5%, and the prevalence was 15.6% and 11.8% in mild and moderate to severe ACHD patients, 17.8% in males and 12.9% in females, respectively, both of which gradually increased with age, with the highest prevalence of 27.4% in the elderly. The abnormal rate of single index was the highest in MS, and the prevalence of decreased high-density lipoprotein cholesterol and central obesity was high, 33.2% and 31.5%, respectively. Multivariate logistic regression analysis showed that male gender, increased body mass index, increased waist circumference, increased systolic blood pressure, increased fasting blood glucose, increased triglycerides, decreased glomerular filtration rate, increased aspartate transferase, and pulmonary hypertension were independent risk factors for MS in ACHD patients(P<0.05). Conclusion: The prevalence of MS in ACHD patients is higher than that in the general population, and MS screening and preventive health education in ACHD patients should be strengthened.

关 键 词：成人先天性心脏病 代谢综合征 患病率 危险因素 

分 类 号：F541.3[经济管理—产业经济]