氯沙坦联合瑞舒伐他汀治疗高血压病并高尿酸血症的疗效观察

高尿酸血症(HUA)是长期嘌呤代谢障碍引起的代谢性疾病,其发生主要与尿酸(UA)生成增多或排出减少有关[1]。研究显示,HUA与高血压、糖尿病和代谢综合征等心血管危险因素关系密切。     

代谢组学在中医药治疗NAFLD中的应用

<正>非酒精性脂肪性肝病(NAFLD)在全球的患病率达25%以上^[1],与肥胖、糖尿病、高脂血症、代谢综合征密切相关^[2-5],是代谢综合征(MS)的主要组成部分,是MS在肝脏中的表现[6]。NAFLD的进展形式,尤其是炎症和纤维化与动脉粥样硬化等心血管疾病密切相关^[7-9]。NAFLD发病机制多与肝脏内部脂质聚积、氧化应激及脂质代谢异常等因素有关[10]。随着研究的深入,发现肠道黏膜通透性降低,     

代谢综合征患者132例高血压治疗效果及其相关性

代谢综合征[1](MS)是一组多种代谢异常聚集的病理状态和临床症候群.代谢异常主要包括高血糖、中心性肥胖、高脂血症、高血压等,具有共同的发病机制.研究表明高血压是导致MS患者死亡的第一危险因素[2],高血压的控制是MS治疗的重要组成部分,本文对MS患者高血压治疗效果的相关性进行了分析.     

精神分裂症患者合并代谢综合征的研究进展

1 代谢综合征 代谢综合征(metablic syndrome,MS)是集肥胖、糖代谢异常、血脂紊乱和高血压等多种代谢危险因子于一身的症候群,是糖尿病和心血管疾病(CVD)发病的独立危险因素,涉及多个学科问题而备受关注.2005年国际糖尿病联盟(IDF)公布[1]代谢综合征的国际通用定义.     

非糖尿病代谢相关脂肪性肝病患者尿液代谢物特征分析

<正>代谢相关脂肪性肝病(MAFLD)的主要病理表现为肝细胞的脂肪沉积超过正常范围,与胰岛素抵抗、遗传等关系密切,是一种与代谢关联紧密的疾病^[1-2]。MAFLD是一种进行性疾病,可直接导致肝硬化、肝癌等肝病,且可能参与2型糖尿病、代谢综合征、动脉粥样硬化性心血管疾病、慢性肾脏病及相关恶性肿瘤的发病^[3-4]。目前,MAFLD的全球患病率约为25%且呈持续增长趋势,由于其对公众健康的影响日益严重,研究防治MAFLD具有重要意义。代谢组学已成为现代研究中发现各个系统疾病相关标志物的新工具^[5-7],可更好地阐述机体变化的代谢结果,提供内源性代谢物的全面概况。基于液相色谱-质谱技术(LC-MS)的代谢组学技术已成功应用于涵盖MAFLD在内的多领域疾病的研究。本文回顾性将其与生物体中发生的潜在生物过程联系起来,可为临床提供更加客观准确的信息。     

库欣综合征的心血管疾病危险因素

库欣综合征患者往往伴有一系列全身性代谢合并症如中心性肥胖、高血压、胰岛素抵抗、糖代谢异常、血脂紊乱、血液高凝状态等。这些表现均为代谢综合征的特征,也是重要的心血管疾病危险因素。库欣综合征与代谢综合征联系密切,可以作为研究代谢综合征的模型。库欣综合征患者治愈、皮质醇水平恢复正常后仍有可能存在与疾病活动期类似的代谢紊乱和心血管疾病危险因素。     

氧化应激与代谢综合征的关系及抗氧化剂的应用

代谢综合征（metabolic syndrome,MS）是多种代谢危险因素簇集在个体上的一种异常病变状态,这些异常包括腹型肥胖、糖耐量异常、高血压、血脂异常等,这些组分以不同形式组合影响机体代谢,主要临床结果为心血管疾病。随着人民生活水平的提高,尤其是饮食模式西方化,运动量减少等因素促成MS发病率明显增加[1],目前已经成为备受关注的公共健康问题。大量研究表明,氧化应激是MS发生和发展的重要病因之一[2],现就氧化应激及MS的关系进行综述。     

关注新命名的代谢相关脂肪性肝病与结直肠癌的关系

<正>结直肠癌(CRC)是全世界范围内最常见的恶性肿瘤之一，世界卫生组织国际癌症研究机构(IARC)发布的全球肿瘤流行病统计数据(GLOBOCAN.2020)估计，2020年全球新发CRC病例约193万，排在常见恶性肿瘤的第3位，死亡病例约为93万，在恶性肿瘤死亡原因中排名第2位^[1]。CRC的发病与遗传、生活习惯以及脂肪肝、超重、肥胖、糖尿病、高血压、血脂异常等代谢因素有关。     

代谢综合征患者主动脉根部及心脏瓣膜构形特点及其影响因素

探讨有或无高血压的代谢综合征（MS）患者主动脉根部及心脏瓣膜病变特点及相关因素。方法：选择我院心内科住院患者350例,按有无高血压分为：无高血压代谢综合征组（MS组,142例）,高血压代谢综合征组（HMS组,208例）;并选择年龄50岁以上同期健康体检者作为健康对照组（60例）,比较三组主动脉根部内径、扩张比例以及心脏瓣膜退行性病变比例,并通过Logistic回归分析主动脉根部扩张的相关危险因素。结果：与健康对照组及MS组比较,HMS组的主动脉扩张病人比例（11.7%比25.4%比40.9%）,主动脉根部扩张比例[（27.5±2.6）mm比（29.1±2.3）mm比（32.8±3.4）mm]显著增加（P〈0.05）。HMS组瓣膜退行性变的比例明显高于MS组（47.8%比31%,P〈0.05）,以主动脉瓣和联合瓣膜病变为主。Logistic多因素回归分析发现,年龄（MS组：OR=1.57,HMS组：OR=1.46）、血脂紊乱（低密度脂蛋白胆固醇：MS组：OR=9.48,HMS组：OR=1.97）、高血压（MS组：OR=1.79/0.81,HMS组：OR=1.79/1.03）是主动脉根部扩张的危险因素（P〈0.05~〈0.01）。结论：高血压是代谢综合征患者主动脉根部扩张的危险因素之一,也与瓣膜退变有关。     

中老年代谢综合征与动脉硬化心脑事件的早期干预

代谢综合征（metabolism syndrome，MS），又称作胰岛素抵抗综合征，是以胰岛素抵抗为中心环节，肥胖为启动因素所引起的代谢紊乱综合征，其组成部分包括中心性肥胖（又称腹部肥胖或内脏性肥胖）、胰岛素抵抗、高血压、高脂血症、高血糖、高血凝和微炎征状态等，这些危险因素最易导致动脉粥样硬化性心血管事件的发生。[第一段]     

前清蛋白与代谢综合征及胰岛素抵抗相关性的人群研究

目的:在社区人群中探讨前清蛋白与代谢综合征及胰岛素抵抗的相关性。方法:按照整群抽样的方法选取上海市嘉定区社区40岁以上居民共2 446名,采集受试者基本信息并测量相关人体学指标,测定血脂、血糖、前清蛋白等生化指标。根据2001年美国国家胆固醇教育计划成人治疗组第3次报告(NCEP-ATPⅢ)诊断标准定义代谢综合征。Pearson相关分析前清蛋白与代谢综合征各个组分以及胰岛素抵抗的相关性。Logistic回归分析前清蛋白与代谢综合征的患病风险之间的关系。结果:随着前清蛋白水平的增加,体质量指数、腰围、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、收缩压、舒张压、空腹胰岛素浓度均升高(均P<0.01),而高密度脂蛋白胆固醇降低(P     

Association between thyroid hormone and components of metabolic syndrome in euthyroid Korean adults: A population-based study

Thyroid dysfunction increases the prevalence of metabolic syndrome. However, the link between thyroid hormones and metabolic syndrome remains debatable, and the effect of sex on their relationship is not completely understood. To elucidate the relationship of thyroid hormones with metabolic syndrome and its components according to sex in euthyroid individuals in South Korea. Adult participants who underwent thyroid tests at our institution between January 2015 and December 2018 and had thyroid-stimulating hormone (TSH; 0.270–4.200 μIU/mL) and free thyroxine (FT4; 0.93–1.70 ng/dL) levels in the normal range were included. After correcting for age and body mass index, multiple linear regression was performed to assess the association of TSH and FT4 with metabolic syndrome and its components, and logistic regression was performed to estimate the risk of developing metabolic syndrome and its components according to different thyroid hormone quartiles. We included 12,478 men and 7,575 women in this study. The prevalence of metabolic syndrome was 9.68%. In men, TSH was positively associated with blood pressure and triglycerides, and the odds ratio for high blood pressure and hypertriglyceridemia was approximately 1.3 times higher in the fourth quartile than in the first quartile. FT4 associated positively with waist circumference, and a high odds ratio for abdominal obesity in the fourth quartile was observed in both men (odds ratio [OR], 1.239; 95% confidence interval [CI], 1.045–1.470) and women (OR, 1.302; 95% CI, 1.029–1.649). A negative association was found between FT4 and triglycerides, and concurrently, the odds ratios for hypertriglyceridemia were lower in the fourth quartile in both men (OR, 0.692; 95% CI, 0.619–0.774) and women (OR: 0.641; 95% CI: 0.512–0.803). In addition, a higher odds ratio for high blood pressure was observed in the fourth quartiles of FT4 and TSH in women. However, there was no association between TSH and FT4 levels and the onset of metabolic syndrome in either of the sexes. Serum TSH and FT4 levels were associated with different metabolic syndrome components in men and women, but there was no association with the onset of metabolic syndrome.     

中老年人血清丙氨酸氨基转移酶水平与代谢综合征的相关性研究

目的 研究中老年人血清丙氨酸氨基转移酶(ALT)水平与代谢综合征的相关性.方法 对上海市宝山区友谊街道1 664名40岁以上居民进行问卷调查、体格检查以及空腹采血检测肝肾功能、血糖及血脂等生化指标.代谢综合征采用按照亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第三次报告(NCEP-ATP Ⅲ)诊断标准.结果 研究对象各主要代谢指标均随着ALT水平的升高而逐渐趋向恶化.代谢综合征的患病率从第一个ALT四分位至第四个ALT四分位分别为29.2%、38.0%、44.9%和62.9%(组间趋势P<0.01).血清ALT水平与代谢综合征及其多个组分的患病风险之间存在显著的剂量一反应关系.相比ALT水平在第一个四分位的研究对象,ALT水平在第四个四分位的研究对象代谢综合征患病风险增加146%,中心性肥胖风险增加204%,高血压风险增加35%,高甘油三酯风险增加133%,高血糖风险增加72%.另外,随着代谢综合征组分个数的增加,ALT水平显著上升(组间趋势P<0.01).结论 中老年人血清ALT水平升高增加代谢综合征的患病风险.     

90岁以上老年男性血尿酸水平及多因素分析

目的 了解高龄老年男性高尿酸血症的发病率及临床特点,探讨其相关影响因素.方法 选择2007年在我院进行常规体检的90岁以上老年男性100例为研究对象,比较不同血尿酸水平人群临床及生化指标,对影响高尿酸水平的诸多因素进行Logistic回归分析. 结果 90岁以上老年男性血尿酸增高的比例为20%,痛风性关节炎的发生率为1%.尿酸增高组血尿素及肌酐水平分别为(10.985±4.29)mmol/L和(125.2±25.9)μmol/L,均明显高于尿酸正常组[(6.87±1.86)mmol/L和(93.4±19.8)μmol/L] (t=-4.460和t=4.279,均为P<0.05).并存高血压、高三酰甘油血症、应用利尿剂的比率高于尿酸正常组(X2=4.762、9.219、4.080,均为P<0.05).Logistic回归分析显示,血尿酸与血肌酐相关性最为明显(OR=1.969),其次为空腹血糖(OR=1.310)和血尿素(OR=1.161),与胆固醇(OR=0.802)呈负相关. 结论 90岁以上老年人高尿酸血症患病率较高,急性痛风性关节炎发病率低;主要危险因素是肾功能下降、高血糖及利尿剂的应用.     

Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese

The relationship between thyroid dysfunction and metabolic syndrome (MS) is complex. We aimed to explore the impact of gender and age on their association in a large Chinese cohort.This cross-sectional study enrolled 13,855 participants (8532 male, 5323 female), who self-reported as healthy without any known previous diseases. Clinical data including anthropometric measurements, thyroid function, and serum metabolic parameters were collected. The associations between thyroid function and MS of both genders were analyzed separately after dividing thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and age into subgroups. MS risks were calculated by binary logistic regression models.Young males had significantly higher MS prevalence than females, yet after menopause, females had higher prevalence than males. Females had higher incidence of thyroid dysfunction than males. By using TSH quartiles as the categorical variables and the lowest quartile as reference, significantly increased MS risk was demonstrated in quartile 4 for males, yet quartiles 3 and 4 for females. By using FT3 quartiles as the categorical variables, significantly increased MS risk was demonstrated in quartile 2 to 4 for females only. By using age subgroups as the categorical variables, significantly increased MS risk was shown in both genders, with females (4.408–58.455) higher than males (2.588–4.943).Gender and age had substantial influence on thyroid function and MS. Females with high TSH and high FT3 had higher MS risks than males. Aging was a risk for MS, especially for females. Urgent need is necessary to initiate interventional programs.     

Association between serum albumin, carotid atherosclerosis, and metabolic syndrome in Japanese individuals

Serum albumin is a maker of nutritional status and possesses antioxidative properties. Here, we have sought to investigate the mode of association between serum albumin levels, metabolic syndrome, and carotid atherosclerosis by analyzing the data of the cross-sectional data from 8143 individuals who underwent general health screening test. After adjusting for age, total cholesterol, and smoking status, the highest quartile of serum albumin (>or=4.7 g/dL) was associated with increased prevalence of metabolic syndrome with an odds ratio of 1.80 (95% CI 1.41-2.23, P<0.0001) in women, and 1.60 (95% CI 1.44-1.78, P<0.0001) in men, when compared to the lowest serum albumin quartile (<4.3g/dL). By contrast, when compared with the lowest quartile, the highest quartile of serum albumin was associated with reduced prevalence of carotid plaque with an odds ratio of 0.62 (95% CI 0.42-0.91, P<0.001) in women, and 0.76 (95% CI 0.62-0.93, P<0.01) in men, and for carotid intima-media thickening with an odds ratio of 0.57 (95% CI 0.35-0.94, P<0.05) in women, and 0.71 (95% CI 0.55-0.92, P<0.01) in men. Our data showed that higher serum albumin was inversely associated with the prevalence of early carotid atherosclerosis, although it was positively associated with the prevalence of metabolic syndrome. Whether these observations are in part explained by the antioxidative properties of albumin requires further investigation.     

Vitamin d intake and status are associated with lower prevalence of metabolic syndrome in u.s. Adults: national health and nutrition examination surveys 2003-2006

Abstract Background: Previous reports have shown that metabolic syndrome and some metabolic syndrome components are associated with serum 25-hydroxyvitamin D [25(OH)D]. Methods: Using the National Health and Nutrition Examination Surveys (NHANES), 2003-2006, we evaluated the associations of vitamin D intake (n=3543) and vitamin D status [25(OH)D; n=3529], with the prevalence of metabolic syndrome and its components in adults 20 years and older. Exclusion criteria included nonfasted subjects, those pregnant and/or lactating, and, for intake analyses, those with unreliable 24-h recall records. Subjects were separately classified into quartiles of vitamin D intake (both including and excluding supplements) and serum 25(OH)D. Logistic regression was used to determine odds ratios (OR) for metabolic syndrome after adjusting for multiple confounders. Results: Those in the highest quartile of serum 25(OH)D had 60% lower odds for metabolic syndrome as compared to those in the lowest quartile [OR=0.40; 95% confidence interval (CI) 0.27, 0.59]. Elevated waist circumference (OR=0.57; 95% CI 0.39, 0.84), low high-density lipoprotein cholesterol (HDL-C) (OR=0.54; 95% CI 0.39, 0.75), and high homeostasis model assessment of insulin resistance (HOMA-IR) (OR=0.40; 95% CI 0.29, 0.55) were the main components associated with serum 25(OH)D. Compared with the lowest vitamin D intake quartile (excluding supplements), those in the highest intake quartile had 28% lower odds for metabolic syndrome (OR=0.72; 95% CI 0.58, 0.90). No components of metabolic syndrome were significantly associated with dietary intake of vitamin D with supplements included or excluded. Conclusions: We conclude that higher 25(OH)D, and, to a lesser degree, greater dietary vitamin D intake, are associated with reduced prevalence of metabolic syndrome.     

老年人高尿酸血症调查及影响因素分析

目的了解老年人(≥60岁)发生高尿酸血症的情况及其临床特点,并探讨出现老年高尿酸血症的相关因素。方法以2003年在我院进行查体的1500名老年人为研究对象,采用酶法在Bek-m anCx—9全自动生化分析仪上测定血尿酸,以血尿酸440μm ol/L为界限,比较分析高尿酸血症组与尿酸正常组的临床指标。对影响高尿酸水平的诸多因素进行Logistic多因素回归分析。结果血尿酸增高患者的比例为17.6%(264/1500)。尿酸增高组的男女比例为256∶8。随各年龄组年龄的增大,血尿酸增高患者的比例、血尿酸、尿素氮、肌酐及甘油三酯平均值均逐渐增高。与尿酸正常组相比,高尿酸血症组的脂肪肝、肥胖症及糖耐量异常的发生率明显增高(P均<0.05),代谢综合征、高血压、氮质血症或肾功能不全及痛风关节炎的发生率明显增高(P均<0.01),平均体重、体重指数、腰围、臀围及腰/臀比也明显增高(P均<0.01),血清胆固醇、尿素氮、肌酐和餐后2h血糖水平明显增高(前者P<0.05,后三者P均<0.01)。Logistic多因素回归分析显示,腰/臀比、体重指数、血清胆固醇和肌酐水平是影响血尿酸的主要相关因素。结论老年高尿酸血症与多种心血管或代谢性疾病相关,腰/臀比、体重指数、血清胆固醇和肌酐水平是影响老年人血尿酸升高的重要相关因素。     

Serum uric acid and metabolic syndrome in Taiwanese adults

A positive association between serum uric acid and metabolic syndrome has been reported, but little information is available about the association between serum uric acid and metabolic syndrome in Taiwanese adults. The purpose of this study was to investigate the association between serum uric acid levels and metabolic syndrome in Taiwanese adults. We performed a cross-sectional study of 2085 men and 1557 women. All of the participants underwent a health screening during the period from January 2005 to December 2005 at a health center of the Shin Kong Wu Ho-Su Memorial Hospital. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The results showed that hyperuricemia was significantly associated with increased risk for hypertriglyceridemia, low high-density lipoprotein cholesterol level, and high blood pressure in men and women. The risk of metabolic syndrome was significantly higher in the fourth quartile than in the first quartile of uric acid level in men (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.06-2.14) and women (OR, 2.33; 95% CI, 1.39-3.93). In addition, uric acid level was inversely associated with hyperglycemia in men. The ORs of hyperglycemia for the second, third, and fourth quartile of uric acid were 0.69 (95% CI, 0.46-1.03), 0.55 (95% CI, 0.37-0.83), and 0.45 (95% CI, 0.29-0.69), respectively, compared with the lowest quartile of uric acid. The results demonstrate that there is a positive association between serum uric acid levels and metabolic syndrome and an inverse association between uric acid and fasting plasma glucose in Taiwanese adults.     

Metabolic syndrome and cardiovascular disease in the elderly: the Progetto Veneto Anziani (Pro.V.A.) study

BACKGROUND AND AIMS: The prevalence of the metabolic syndrome increases with age, although only few data are available about its prevalence in the general elderly population. This study describes the prevalence of the metabolic syndrome in an elderly population, and its association with cardiovascular diseases. METHODS: The Progetto Veneto Anziani (Pro.V.A.) is an observational study of 3,099 subjects aged 65 and older, randomly selected from the general population of Northern Italy. Cardiovascular diseases and metabolic syndrome according to Adult Treatment Panel III were evaluated in 2,910 subjects. RESULTS: The metabolic syndrome was present in 25.6% of men and 48.1% of women. Its prevalence was mainly due to high blood pressure (93%) in both sexes, and to abdominal obesity in 73% of women. The prevalence of cardiovascular diseases was significantly higher among subjects with metabolic syndrome. Together with age and former smoking habits, the metabolic syndrome was significantly associated with cardiovascular diseases. High blood pressure and low HDL were independently associated with cardiovascular diseases in men, and with high fasting plasma glucose and waist circumference in women. CONCLUSIONS: The metabolic syndrome is frequent, and significantly but not independently associated with prevalent cardiovascular diseases in the elderly. In old people, rather than the metabolic syndrome per se, some of its components are independently associated with cardiovascular diseases.