广东省6188名3至14岁儿童血脂水平及影响因素分析

目的了解广东省3～14岁儿童血清胆固醇、甘油三酯、高密度脂蛋白胆固醇的水平及相关影响因素。方法运用多阶段整群随机抽样方法,抽取广东省大城市、中小城市、2类农村各3个区（县）,1类农村4个县,每个县（区）抽取3个街道（乡）、6个居委会;共对3～14岁6188名儿童检测了血脂。用面对面询问调查获得儿童个人及家庭基本情况,体检获取体重、身高数据;血脂采用酶法进行检测,使用Saturno 300生化分析仪和日立7060自动生化分析仪进行测定。结果经过标准人口年龄构成及地区人口权重处理后,广东省3～14岁儿童甘油三酯（TG）、胆固醇（TC）、高密度脂蛋白胆固醇（HDL—C）均值分别为0．80mmol／L,3．50mmol／L,1．28mmol／L。TG均值大城市与1类农村,中小城市与2类农村之间差异无统计学意义（P〉0．05）。TC均值中小城市最高（4．00mmol／L）,其次是大城市（3．72mmol／L）,1类农村与2类农村之间差异无统计学意义（P〉0．05）。四类地区HDL—C均值两两之间均有统计学意义。儿童高TG、高TC和低HDL—C的百分率分别为2．2％,2．1％和8．0％。城市、1类农村、男性、低体重及7．0～9．9岁为高TG的保护因素;对于高TC,家庭人口数3～4人,年龄7．0—9．9岁,大城市、中小城市和1类农村都是危险因素;男性,家庭经济收入800～9999元,中小城市,1类农村是低HDL—C的保护因素。结论广东省儿童血脂仍然处于较低的水平,居住地区、家庭人口数、年龄和性别是血脂的主要影响因素,但对TG、TC和HDL—C水平的影响是不同的。     

踝臂指数与心血管病危险因素的关系

目的 探讨中国北方人群踝臂指数作为新的危险因素预测指标与心血管病危险因素之间的关系.方法 选自2007年1月至2007年7月我院住院患者,均有1个以上的心血管病危险因素.取其资料完整者500例作为研究对象,同时选取除无心血管病危险因素外,在年龄、性别等因素与研究对象相匹配300例作为对照组.分别测量两组身高、体重(计算体质指数)、血压,并进行血液生物化学指标检查,包括血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇.采用Md2双向多普勒超声仪,8 MHz新一带宽幅多普勒探头进行踝臂指数的测量及判定.采用Logistic回归分析踝臂指数与年龄、性别、身高、体重、血压、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇之间的关系.结果 年龄、高血压、糖尿病、吸烟为低踝臂指数(踝臂指数＜0.9)的主要影响因素.其中男性踝臂指数异常的相关危险因素有年龄、血糖、血压和吸烟;女性踝臂指数异常的相关危险因素有年龄、血糖和吸烟.结论 踝臂指数与心血管病危险因素之间存在聚集关系.踝臂指数与年龄、高血压、糖尿病、吸烟等相关;踝臂指数值降低增加心血管病的发病危险.     

北京部分职业人群血清非高密度脂蛋白胆固醇参考值及其分布

非高密度脂蛋白胆固醇代表除高密度脂蛋白胆固醇以外一切有致动脉粥样硬化作用的脂蛋白(以胆固醇含量表示)的总和,用总胆固醇减去高密度脂蛋白胆固醇即可算出.为了解北京部分职业人群非高密度脂蛋白胆固醇的参考值及其分布,选择调查2000～2001年来院体检的北京市事业及企业单位干部与职工(不包括体力劳动者),共计28161人(男/女为6/4),年龄20～85岁.按标准化要求空腹测定总胆固醇、高密度脂蛋白胆固醇及甘油三酯水平,以Freidewald公式计算低密度脂蛋白胆固醇水平.结果发现,非高密度脂蛋白胆固醇随年龄上升,50岁以下男性高于女性,50岁以上女性高于男性.非高密度脂蛋白胆固醇年龄标化均值男为3.47mmol/L、女为3.29mmol/L,但老年男为3.90mmol/L、老年女高达4.21mmol/L.假定甘油三酯在临界值(1.7mmol/L)时,非高密度脂蛋白胆固醇比低密度脂蛋白胆固醇高0.77mmol/L,由于该组人群甘油三酯水平较低,各年龄组两项指标的差距都或多或少地低于0.77mmol/L.调查所得非高密度脂蛋白胆固醇水平比美国全国有代表性的数据大约低20%(男女相近),以上表明北京部分职业人群动脉粥样硬化性心血管病危险明显低于美国人.     

大连市獐子岛地区心血管疾病危险因素的流行病学调查

目的了解獐子岛地区居民心血管疾病的危险因素发生情况,为实施心血管疾病干预措施提供依据。方法按年龄性别随机分层抽取獐子岛镇18岁以上常驻居民(≥5年)1024例,进行心血管疾病危险因素流行病学调查,并对35~59岁人群用"国人缺血性心血管病十年发病危险度评估表"进行评估,对结果进行统计学分析。结果(1)高血压、高总胆固醇、高低密度脂蛋白胆固醇、低高密度脂蛋白胆固醇、高三酰甘油、糖尿病、高尿酸血症患病率依次为43.8%、28.4%、12.4%、9.4%、21.7%、7.2%、9.8%。吸烟率27.1%,超重率56.3%,高摄盐率56.2%。(2)具有1个以上危险因素的个体占89.8%,无同时≥8个以上危险因素的个体。男性具有1个以上危险因素者比例大于女性,差异具有统计学意义(P<0.01)。(3)10年缺血性心血管病发病危险度<10%(低危):男性为96.3%,女性为94.4%;≥20%(高危):男性为1.5%,女性为0.4%。不同性别10年缺血性心血管病发病危险度在中高危以上(≥10%)检出率差异无统计学意义(P>0.05)。结论獐子岛地区心血管疾病危险因素的人群比例高,应积极加强对心血管疾病危险因素干预。     

宁波市人群血尿酸水平及其影响因素

目的:分析本地区不同年龄阶段人群的血尿酸水平及其影响因素。方法:记录在本院进行体检的24965人的性别、年龄,测量受检者的身高、体重、血压、进行血生化检测,按年龄进行分组,并进行统计学分析。结果:男性血尿酸水平高于女性(P<0.01)。女性血尿酸水平随年龄增长的幅度明显,各年龄组间比较均有显著性差异(P<0.01)。在50岁以下人群中血尿酸水平与年龄、性别、体重指数、舒张压、总胆固醇、甘油三酯呈正相关(P<0.01),与空腹血糖、低密度脂蛋白、高密度脂蛋白呈负相关(P<0.01)。70岁以上人群中血尿酸与年龄、性别呈正相关(P<0.05),与血糖成负相关(P<0.01)。结论:中青年人群血尿酸水平升高与多种心血管危险因素显著相关,老年人血尿酸水平的相关因素与中青年不同,在干预上应分别对待。     

北京城,乡心血管病危险因素变化趋势（1984—85至1988—89）：北…

我们于１９８４－８５年和１９８８－８９年在北京市心血管病监测区分别随机抽取年龄在２５－６４岁者１，６７３作１，５５７人进行两次心血管病危险因素调查，第一次调查城市居民１，１２７人，农村４３０人。北京市和郊区农村的几个心血管病危险因素的变化趋势并不完全一致，其中城区和郊区农村的平均血总胆固醇水平，高密度脂旦白胆醇和ＢＭＩ均上升，城市男性一吸烟率仍在上升，女性吸烟率和农村居民的吸烟率都有下降的趋势。城     

江苏省农村人群心血管病危险因素水平变化趋势─（1989～1993年）江苏省Monica研究

为动态观察人群心血管病危险因素水平的变化趋势，按照ＷＨＯ－Ｍｏｎｉｃａ方案要求，我们对江苏省农村海门县地区人群的有关心血管病危险因素水平进行了抽样调查，以了解该人群的血压、总胆固醇（Ｔｃ）、高密度脂蛋白胆固醇（ＨＤＬ－ｃ）、体重指数（ＢＭＩ）水平以及人群的吸烟率、高血压患病率的状况。其结果显示：男性血压、Ｔｃ、ＢＭＩ及高血压患病率较前明显上升（ｐ＜０．０１），吸烟率则下降。女性血压水平、高血压患病率及ＢＭＩ同样较前明显升高。鉴于此，我们认为该地区五年来心血管病危险因素水平的总趋势是上升了，提出应重视开展人群防治工作，控制人群心血管病危险因素水平的增长，以最终达到有效降低心血管病发生之目的。     

北京市城、乡心血管病危险因素变化趋势 (1984-85至1988-89):北京MONICA研究

我们于1984-85年和1988-89年在北京市心血管病监测区分别随机抽取年龄在25-64岁者1,673人和1,557人进行两次心血管病危险因素调查,第一次调查城市居民1,302人,农民371人;第二次调查城市居民1,127人,农村430人。北京市和郊区农村的几个心血管病危险因素的变化趋势并不完全一致,其中城区和郊区农村的平均血总胆固醇水平,高密度脂旦白胆固醇和 BMI 均上升,城市男性吸烟率仍在上升,女性吸烟率和农村居民的吸烟率都有下降的趋势。城市居民无论男性还是女性,平均舒张压水平均有所下降而郊区居民平均收缩压和平均舒张压均有所上升。北京70万人群心血管病五年监测结果显示北京市郊区脑卒中的发病率高于城市,而急性冠心病事件的发病率低于城市,结合危险因素分析,郊区的高血压患病率高于城市居民,胆固醇水平低于城市居民可能是郊区和城区脑卒中,冠心病事件发病率不同的原因。     

高密度脂蛋白胆固醇与冠心病的相关性研究

高密度脂蛋白胆固醇降低是动脉粥样硬化性心血管病的独立危险因素,血浆中高密度脂蛋白胆固醇的水平与冠心病发生呈负相关,其机制包括高密度脂蛋白逆转运胆固醇、抗氧化、促纤溶、抗血栓等作用。目前对于低高密度脂蛋白胆固醇血症患者的干预主要有生活方式改变,药物治疗,以及新近的生物疗法等策略,达到降低心血管事件的发生率。     

老年男性外周动脉疾病与骨质疏松的相关性

目的 探讨老年男性外周动脉疾病与骨质疏松之间的相关性.方法 选取222例查体老年男性患者,按踝臂指数<0.9者入选外周动脉疾病组(87例),踝臂指数≥0.9者为非外周动脉疾病组(135例).收集两组患者身高、体重、骨密度、踝臂指数、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等指标进行组间比较及相关性分析.结果 两组老年男性除年龄差异有显著性外,其余各项骨密度指标无统计学差异.相关分析表明双侧踝臂指数与髋部骨密度呈显著正相关(r=0.254、0.208、0.247,P<0.01),且二者分别与身高、体重、低密度脂蛋白显著相关(P<0.01),与舒张压有相关性(P<0.05),而与年龄呈显著负相关(P<0.01).结论 提示外周动脉疾病与骨质疏松之间可能存在共同危险因素.     

上海市社区60岁以上人群脂肪肝患病率及危险因素的横断面研究

目的了解上海市社区60岁以上人群脂肪肝的患病率及危险因素。方法对闵行区梅陇社区7534名60岁以上人群定期体检,填写统一设计的调查表,内容包括:一般情况、实验室检查、B型超声检查结果等。结果其中女性4198名,男性3336名,女男之比为1.26:1,平均年龄(68.8±7.0)岁。经B型超声检出脂肪肝3074例,占40.80%。60岁以上老年人脂肪肝患病率随着年龄增加而呈下降趋势,患病率最高的年龄段为60～64岁,达到45.20%。80岁以下,女性患病率显著高于男性。脂肪肝组的体质指数(BMI)、腰围、腰臀比(WHR)、三酰甘油、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、收缩压(SBP)、ALT、γ-谷氨酸转肽酶(GGT)等指标显著高于非脂肪肝组,而高密度脂蛋白胆固醇(HDL-C)则低于非脂肪肝组。相比正常对照组,肥胖、中心性肥胖和高脂血症分别增加脂肪肝患病风险15.2倍、10.8倍和8.6倍(P<0.01)。多元回归分析发现,女性、BMI、SBP、三酰甘油、HDL-C、LDL-C、TC、ALT、GGT等9项指标与脂肪肝密切相关。结论上海市社区60～64岁人群脂肪肝患病率较高,与肥胖及脂代谢紊乱密切相关。     

体脂分布类型和胰岛素抵抗对心血管病危险因素聚集性的 …

目的：探讨体脂分布类型和胰岛素抵抗对心血管病危险因素聚集性的影响。方法在自然人群中调查体重指数（ＢＭＩ）、腰围／臂围比值（ＷＨＲ）、血压、血胆固醇（ＴＣ）、甘油三酯（ＴＧ）、高密度脂蛋白－胆固醇（ＨＬＤ－Ｃ）、血糖（ＦＢＳ）、胰岛素（ＩＮＳ）及胰岛素敏感性指数（ＩＳＩ）。结果外周型超重组血压、ＴＧ、ＩＮＳ高于非超重组,ＨＤＬ－Ｃ、ＩＳＩ低于非超重组;而中心型超重组血压、ＩＮＳ及危险因素聚集程度高于     

THE INTERACTIONS OF BODY WEIGHT, AGE, CIGARETTE SMOKING AND HORMONE USAGE WITH BLOOD PRESSURE AND PLASMA LIPIDS IN AN AUSTRALIAN COMMUNITY

The predicted variation of blood pressure and plasma lipid levels, based on association with body weight, age, cigarette smoking and oral contraceptive usage, was examined in 47 000 self-referred subjects who attended a community programme for coronary risk factor screening. In both sexes, blood pressure and plasma lipid (cholesterol and triglyceride) levels were positively correlated with age and body mass index (BMI, kg/m²). Plasma triglyceride concentrations were positively correlated with cigarette smoking. Partial correlation analysis showed age and BMI to be independently correlated with blood pressure and plasma lipids. Plasma cholesterol and triglyceride levels were correlated with each other independently of the effects of age and BMI. Multiple regression analysis showed age to be a more powerful predictor of blood pressure and plasma lipid levels in females than in males, while BMI was a more powerful predictor of blood pressure and plasma lipid levels in males than in females. Current cigarette smoking did not contribute to the prediction of blood pressure or plasma cholesterol level in either sex, but did predict a 10% higher plasma triglyceride level in both sexes. Oral contraceptive usage did not contribute to the prediction of plasma cholesterol level in multiple regression analysis, but did predict higher plasma triglyceride and blood pressure levels. In view of the high prevalence of overweight people in the Australian community, weight reduction would probably be associated with a significant fall in the risk of coronary heart disease, particularly in males.     

东北地区城市脂肪肝的患病率及其危险因素的流行病学调查

目的探讨东北地区成人脂肪肝的流行病学特征及其危险因素。方法选取2009年1月~2009年12月具有完整资料的某体检中心的健康体检者15 635例,其中男9 037例,女6 598例,男女之比为1.37：1,年龄16~95岁,平均年龄（47.85±13.21）岁。通过性别、年龄分层后比较脂肪肝的患病率,并将脂肪肝患者的体质量指数、血压、血脂、血糖、尿酸、血常规、肝功能等检测结果与非脂肪肝组进行对比分析。结果 B超共检出脂肪肝患者5 955例,总患病率为38.1%,男性患病率显著高于女性（48.8%vs23.4%,χ2=1039.853,P〈0.001）;30~69岁的男性脂肪肝的患病率超过50%,尤以40~49岁最高（55.2%）,女性在39岁之前脂肪肝的发生率不足10%,50岁后骤然上升至35%以上,60~69岁达到高峰并超过男性（43.4%vs40.5%）,70岁以后女性脂肪肝患病率仍显著高于同龄男性（35.5%vs28.3%,χ2=7.670,P〈0.006）。非脂肪肝人群超重者占35.6%,肥胖占7.5%,而脂肪肝人群两者分别为51.0%,36.8%。脂肪肝组的血压、血糖、甘油三酯（TG）等增高的检出率明显高于非脂肪肝组,高密度脂蛋白胆固醇（HDL-C）降低的检出率明显低于非脂肪肝组（P均〈0.001）。单因素分析显示,体质量指数（BMI）、收缩压、TG、空腹血糖（FBG）和血尿酸（UA）,以及γ谷氨酰基转移酶和丙氨酸氨基转移酶在脂肪肝组明显高于非脂肪肝组（P均〈0.001）;相反,HDL-C则显著低于非脂肪肝组（t=47.174,P〈0.001）。多因素Logistic回归分析提示,脂肪肝危险因素包括BMI、TG、UA、FBG、舒张压、胆固醇等,OR值分别为3.590、1.936、1.567、1.508、1.346和1.177。结论东北地区城市男女脂肪肝的发生率在各年龄段有明显差异,脂肪肝的发生与代谢综合征的组分明显相关,尿酸的增高也与脂肪肝的发生明显相关。     

1984—1999年北京城乡人群心血管病危险因素变化趋势的研究

目的:描述1984—1999年北京城乡人群心血管病主要危险因素的流行状况,对比并评价心血管病危险因素的变化趋势。方法:分别于1984—1985年,1988—1989年,1993年,1996年和1999年采用相同的方法,在北京市25~64岁人群中进行了5次独立的心血管病危险因素调查。按性别、城乡分组,比较各种危险因素在城乡人群中的不同变化趋势。结果:从1984—1999年,北京市城乡人群心血管病危险因素的变化趋势:1.城市人群的收缩压、舒张压水平和高血压患病率呈下降趋势,城市男性的下降趋势有统计学意义;而农村人群的收缩压、舒张压水平和高血压患病率则均呈上升趋势。2·各组人群的血清总胆固醇水平和高胆固醇血症患病率均呈上升趋势。15年间,城乡男性的血清总胆固醇水平每年分别增加0·06mmol/L(2·3mg/dL)和0·08mmol/L(3·1mg/dL)。3·除城市女性外,其他各组人群的体重指数(BMI)水平、腰围、超重+肥胖率(BMI≥24)、肥胖率(BMI≥28)和腹型肥胖率均呈上升趋势。4·吸烟支数和吸烟率在农村男性中呈上升趋势,在其他各组人群中则呈现下降趋势。尤其在女性中下降趋势有统计学显著性。结论:北京城乡人群的多项心血管病危险因素水平呈不同的变化趋势。农村人群的危险因素水平普遍高于城市人群,均呈上升趋势。今后应加强对农村人群的心血管病防治工作。     

Association of age and sex with cardiovascular risk factors and insulin sensitivity in overweight children and adolescents

To determine the effect of age and sex on cardiovascular risk factor expression in overweight children, data from clinical records of 497 overweight children (2-18 years of age) were examined. Data included average blood pressure (BP), fasting lipids, glucose, and insulin. The sample was stratified by age (younger than 11 and 11 years and older) and analyzed by sex. Subjects with an average BP > or = 90th percentile were classified as having high BP. Insulin and glucose were used in equations to estimate insulin sensitivity. Among subjects 11 years and older (n = 268), 52.6% of males had high BP compared with 32.6% of females (P < .001). Mean high-density lipoprotein cholesterol was lowest in the males 11 years and older compared with the females and younger males (P < .01). Triglyceride levels trended higher in males independent of age. In multivariate analyses, high BP was most strongly associated with age and severity of overweight while triglyceride level was most associated with sex and insulin resistance. The prevalence of high BP and dyslipidemia in overweight children is high. Overweight males 11 years and older have a higher prevalence of high BP and low high-density lipoprotein cholesterol than females and younger males. Greater cardiovascular risk factor expression in overweight males 11 years and older may explain the earlier appearance of cardiovascular disease end points in overweight men.     

Sex- and BMI-related differences in risk factors for coronary artery disease in patients with type 2 diabetes mellitus

There are contrasting data about the relationship between obesity and macrovascular complications in type 2 diabetes mellitus, and it is not known if risk factors for coronary artery disease are different in normal weight and overweight or obese patients. All 2113 patients with type 2 diabetes mellitus referring to the Diabetic Clinic of Asti were studied. Patients were divided into tertiles of body mass index, according to their sex (BMI < 26.9; ≥ 26.9 and < 31.4; ≥ 31.4 kg/m² for females and BMI < 25.7; ≥ 25.7 and < 28.8; ≥ 28.8 kg/m² for males). Age, BMI, duration of diabetes, blood pressure, HbA_1c total cholesterol, HDL-cholesterol, LDL-cholesterol, and prevalence of insulin treatment and hypertension were higher in females, whereas exercise, alcohol intake, smoking habits and prevalence of dyslipidemia were higher in males. An increase in BMI was associated with an increase in HbA_1c, number of cigarettes/day, blood pressure, triglycerides, C-peptide, prevalence of hypertension and dyslipidemia, and with a decrease in age, duration of diabetes and HDL-cholesterol values. In spite of an apparently worse cardiovascular risk profile, females showed a 50% lower prevalence of CAD than males and the prevalence of CAD was not significantly different in obese compared to other BMI categories. Multiple logistic regression showed that risk factors for CAD were different in males and females and similar in the lower tertiles of BMI, while different in the highest. In obese females, risk factors for CAD were age, reduced HDL-cholesterol and increased HbA_1c levels; in males they were years of smoking and duration of diabetes. These data suggest that in type 2 diabetes, risk factors for CAD are different in the two sexes and in patients with the highest BMI compared to the normal and overweight subjects; blood glucose control and duration of diabetes seem more important than conventional cardiovascular risk factors in obese patients. Received: 11 May 1998 / Accepted in revised form: 30 July 1999     

Metabolic profile and exercise capacity outcomes: their relationship to overweight and obesity in a Canadian cardiac rehabilitation setting

PURPOSE: Obesity remains a significant health problem for cardiac rehabilitation patients. The purpose of this study was to examine the relation of overweight and obesity to cardiovascular risk factors in patients, and to compare the change in cardiovascular risk factor profiles in patients with coronary artery disease undergoing cardiac rehabilitation at a tertiary care hospital center in Ontario, Canada. METHODS: Retrospective analysis of cross-sectional data for 3542 patients, ages 63 +/- 11 years, stratified by body mass index (BMI), was performed. RESULTS: The findings showed that 81% of the patients had a BMI exceeding 25 kg/m(2), and that 35% of the patients were obese (BMI > or =30 kg/m(2)). After adjustment for age, sex, smoking, hypertension, diabetes, and peak power output, BMI was a significant independent predictor of a higher total cholesterol level, higher fasting blood glucose and triglyceride levels, and lower levels of high-density lipoprotein cholesterol. The Adult Treatment Panel III criteria were used to examine the prevalence of the metabolic syndrome for each BMI group. At baseline, 77% of the obese males in classes 2 and 3 had three or more risk factors for the metabolic syndrome, as compared with 68% of the obese females in classes 2 and 3. After 24 weeks of intervention, the outcome data for 1353 patients showed that despite no change in body weight, all the BMI groups demonstrated significant improvements in metabolic profiles and peak exercise capacity. CONCLUSIONS: Cardiac rehabilitation results in significant improvement in the cardiovascular risk profile at all levels of BMI, independently of weight loss. Future studies should examine whether targeting weight loss in cardiac rehabilitation further improves outcomes and the overall cardiovascular risk profile.     

Relation between obesity and the attainment of optimal blood pressure and lipid targets in high vascular risk outpatients

Obesity is associated with hypertension, dyslipidemia, and diabetes, but it is also an independent cardiovascular risk factor. We sought to evaluate the differences in treatment patterns and attainment of guideline-recommended targets among high-risk vascular outpatients in relation to their body mass index (BMI). The prospective Vascular Protection and Guideline Orientated Approach to Lipid Lowering Registries recruited 7,357 high-risk vascular outpatients in Canada from 2001 to 2004. We stratified the patient population into 3 groups according to their BMI: normal weight (BMI <24.9 kg/m2), overweight (BMI 25 to 29.9 kg/m2), and obese (BMI >30 kg/m2). We evaluated the rates of attainment for contemporary guideline targets of blood pressure (<140/90 or <130/80 mm Hg in the presence of diabetes) and lipids (low-density lipoprotein [LDL] <2.5 mmol/L [96.7 mg/dl] and total cholesterol [TC]/high-density lipoprotein [HDL] ratio <4.0). Of the 7,357 patients, 1,305 (17.7%) were normal weight, 2,791 (37.9%) overweight, and 3,261 (44.4%) obese, as determined by the BMI. Obese patients were younger and more likely to have hypertension and diabetes (all p <0.001 for trend). Obese patients had higher baseline blood pressure, TC, LDL cholesterol, triglyceride levels and TC/HDL ratio, and lower HDL cholesterol. Obese patients were more likely to be treated with antihypertensive agents (p = 0.002), angiotensin-converting enzyme inhibitors (p = 0.024), angiotensin receptor blockers (p <0.001), and high-dose statin therapy (p = 0.001). On multivariable analyses, obese patients were less likely to attain the blood pressure (odds ratio 0.77, 95% confidence interval 0.66 to 0.90, p = 0.001) and TC/HDL ratio (odds ratio 0.48, 95% confidence interval 0.42 to 0.55, p <0.001) targets but not the LDL targets (odds ratio 0.89, 95% confidence interval 0.78 to 1.03, p = 0.11). In conclusion, only a minority ambulatory patients at high cardiovascular risk achieved both guideline-recommended blood pressure and lipid targets, and this significant treatment gap was more pronounced among obese patients. Our findings underscore the opportunity to optimize the treatment of these high-risk patients.     

Obesity increases the risk of development of atherosclerosis in elderly type 2 diabetic patients*

Background: Obesity has been suggested to have no effect on the rates of mortality from cerebro‐ and cardiovascular diseases in the elderly. The purpose of the present study was to determine whether obesity influences atherosclerotic risk factors in elderly diabetic patients. Methods: The relationships between body mass index (BMI) and representative atherosclerotic risk factors were investigated using data from patients with type 2 diabetes who were aged from 65 to 91 years (mean ± standard deviation, 72.3 ± 5.2 years). Results: BMI significantly correlated with systolic and diastolic arterial pressures and serum triglyceride, uric acid and sialic acid levels. BMI also showed significant negative correlations with duration of diabetes and serum HDL cholesterol levels. Multiple regression analysis using BMI as a target variable and age, sex, duration of diabetes, mean arterial pressure, serum uric acid and triglyceride as explanatory variables showed that BMI significantly correlated with arterial pressure and serum triglyceride level (R = 0.459). After adjustment for history of drug therapy for each disease (hypertension, dyslipidemia or hyperuricemia), BMI also significantly correlated with arterial pressure, serum triglyceride, HDL cholesterol and uric acid levels. In the subjects with BMI of 25 or over, the mean levels of systolic and diastolic arterial pressures, serum triglyceride and sialic acid were higher and the mean level of serum HDL cholesterol was lower, after adjustment for age and sex, than those in the subjects with BMI below 22. Conclusion: These results suggest that obesity is related to arterial pressure, blood lipid and uric acid levels and increases the risk of development of atheroclerosis in elderly diabetic patients.