健康体检人群性别和血尿酸与肱-踝脉搏波速度的关系

目的探讨不同性别健康体检人群血尿酸与肱一踝脉搏波速度（baPWV）的关系。方法采用横断面研究的方法对1418例常规健康体检者收集生化指标,并测量baPWV。BaPWV≥1400cm／s定义为baPWV异常。分别根据男女性血尿酸水平的四分位数,将人群分为4组（Q1、Q2、Q3和Q4组）。Spearman相关分析不同性别血尿酸水平与baPWV的关系。在女性logistic回归分析血尿酸水平与baPWV异常的关系。结果男性和女性均有舒张压、空腹血糖、三酰甘油和体质指数随血尿酸水平增高而增高;高密度脂蛋白一胆固醇随血尿酸水平增高而降低。女性收缩压、总胆固醇和低密度脂蛋白-胆固醇水平和baPWV水平亦随血尿酸增高而升高,差异有统计学意义。相关分析显示女性血尿酸与baPWV显著正相关（r=0．18,P〈0．05）,男性血尿酸与baPWV未见相关（r=-0．05,P=0．16）。对女性人群单因素logistic分析结果表明,与血尿酸最低4分位组相比,最高4分位组baPWV异常的发病相对风险OR=2．69（95％CI1．68～4．29）。在校正肌酐和估算肾小球滤过率后,血尿酸第4分位组相对第1分位组baPWV异常的相对风险OR=2．45（95％CI1．48～4．06）。进一步用年龄和MS各组分校正后血尿酸与baPWV相关性消失OR=1．15（95％CI0．56～2．37）。结论女性血尿酸水平与baPWV异常的相关依赖于年龄和MS的组分。     

体检人群肥胖与血浆致动脉硬化指数相关性分析

目的 分析探讨体检人群肥胖与血浆致动脉粥样硬化指数(atherogenic index of plasma, AIP)的相关性。方法 选取2019年1月～12月在解放军联勤保障部队第九八〇医院健康医学科参加体检者52 701例,计算肥胖的总检出率,比较肥胖组与非肥胖组及不同AIP水平的相关代谢指标,同时行体质量指数(BMI)与各项指标的相关性分析及肥胖发病相关因素的logistic回归分析,比较AIP及三酰甘油(TG)和高密度脂蛋白胆固醇(HDL-C)联合预测肥胖的价值。结果 52 701例体检人群肥胖检出9 638例,总检出率为18.29%。肥胖组AIP和收缩压(SBP)和舒张压(DBP)、空腹血糖(FPG)、血清总胆固醇(TC)、TG、低密度脂蛋白胆固醇(LDL-C)均高于非肥胖组,而HDL-C低于非肥胖组,差异有统计学意义(Z=-65.823、-53.031、-55.433、-40.972、-15.085、-60.505、-14.462、-51.668,P<0.05)。随着AIP水平的增加,SBP、DBP、FPG、TC、LDL-C、BMI水平逐渐增加,不同AIP水平分组各指...     

代谢正常肥胖人群的临床表型分析

目的:了解代谢正常肥胖个体(MHO)的临床特点.方法:收集180例体检人群资料,其中正常对照组、代谢正常肥胖组和肥胖伴代谢综合征组各60例.观察空腹血糖(FDG)、糖负荷后2小时血糖(2hBG)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、血肌酐(SCr)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转移酶(GGT)、估算的肾小球滤过率(eGFR)、体质指数(BMI)和其他躯体指标的差异.结果:MHO组BMI、腰围、ALT、GGT均明显高于正常对照组(P<0.05),低于肥胖伴代谢综合征组(P<0.01).MHO组收缩压、舒张压、FBG、2hBG、TG、HDL-C、LDL-C、AST、eGFR与正常对照组比较均无明显差异(P>0.05),明显低于肥胖伴代谢综合征组(P<0.01).多元逐步回归分析提示TG、BMI为ALT、GGT的主要影响因素.结论:MHO个体具有发生代谢异常风险,并非健康的无害状态.     

健康体检人群肝功能与动脉硬化的关系CSCD

目的研究体检人群中肝功能与动脉硬化的关系。方法纳入2017年1至12月在武汉同济医院健康管理中心体检、年龄≥18岁且研究变量无缺失的体检者9111例。根据臂踝动脉脉搏波传导速度(baPWV)将体检者分为动脉硬化组(3252例)和正常组(5859例)。检测两组体检者肝功能指标,包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)和谷氨酰转肽酶γ(GGT)。将肝功能4项指标按照四分位数分为4组(Q1~Q4组)。采用logistic回归分析及限制性立方样条函数研究肝功能与动脉硬化的关系。结果以ALT作为分组变量时,调整了年龄、性别后,Q2到Q4组的动脉硬化的发生风险分别是Q1组的1.260倍(95%CI:1.093~1.452,P<0.05)、1.571倍(95%CI:1.355~1.822,P<0.001)和2.436倍(95%CI:2.097~2.830,P<0.001);调整了年龄、性别、体质指数、低密度脂蛋白胆固醇(LDL-C)、三酰甘油和高密度脂蛋白胆固醇(HDL-C)后,Q2到Q4组的动脉硬化的发生风险分别是Q1组的1.158倍(95%CI:1.003~1.338,P<0.05)、1.331倍(95%CI:1.143~1.551,P<0.001)和1.867倍(95%CI:1.591~2.190,P<0.001);调整了年龄、性别、体质指数、LDL-C、三酰甘油、HDL-C、收缩压、舒张压、心率、空腹血糖、血尿酸、血肌酐、是否患高血压和是否患糖尿病后,Q2到Q4组的动脉硬化的发生风险分别是Q1组的1.116倍(95%CI:0.940~1.325,P=0.210)、1.241倍(95%CI:1.036~1.488,P<0.05)和1.598倍(95%CI:1.322~1.932,P<0.001)。限制性立方样条回归分析显示,ALT与动脉硬化风险之间呈线性正相关。AST、ALP和GGT所得到的结果与ALT类似。结论肝功能指标升高与动脉硬化的发生风险呈正相关。     

肥胖与代谢综合征的相关性研究

目的 研究肥胖与代谢综合 征的相关性。方法对697例年龄为35～60岁者进行体检，根据体重指数（BMI）分为正常、超重、肥胖三组。按照WHO对于代谢综合征血脂代谢异常的诊断标准，在不同的BMI组别，进行高甘油三酯血症、低高密度脂蛋白-胆固醇血症以及高血压、高血糖、高尿酸血症检出率的比较。结果 BMI越高，高甘油三酯血症和低高密度脂蛋白-胆固醇血症的检出率越高，高血压、高血糖、高尿酸血症的检出率亦越高，其组问差异有统计学意义（P〈0．01）。结论 肥胖是代谢综合征的一个重要临床表现，也是高血压病、冠心病、高脂血症、2型糖尿病等的重要危险因素。     

健康体检中超重与肥胖人群的分布特征分析

目的了解健康体检中超重与肥胖的人群分布特征及该人群高血压、高脂血症及糖尿病的患病情况,为慢性疾病的预防及健康管理的研究提供基础资料。方法以北京市某健康体检中心一年的体检者为研究对象,对健康体检中超重及肥胖人群的年龄、性别分布特征进行描述,并对超重组、肥胖组和正常组中高血压、高脂血症及糖尿病的患病率进行比较分析。结果共调查23 767人,其中男性14 259人,女性9508人。超重发生率为31.24%,男性超重发生率为37.82%,女性为21.36%。肥胖的发病率为10.81%,男性肥胖的比例为14.12%,女性为5.84%,男女之间超重及肥胖发生率的差异均有统计学意义（P〈0.01）;正常组、超重组和肥胖组的高血压、高脂血症及糖尿病的患病率在不同性别间的差异均存在统计学意义（P〈0.01）。结论超重和肥胖与高血压、高脂血症和糖尿病的发生有着密切的联系,应将健康管理作为预防慢性疾病发生的重要手段。     

肥胖与代谢综合征的相关性研究

目的研究肥胖与代谢综合征的相关性。方法对697例年龄为35~60岁者进行体检,根据体重指数(BMI)分为正常、超重、肥胖三组。按照WHO对于代谢综合征血脂代谢异常的诊断标准,在不同的BMI组别,进行高甘油三酯血症、低高密度脂蛋白-胆固醇血症以及高血压、高血糖、高尿酸血症检出率的比较。结果BMI越高,高甘油三酯血症和低高密度脂蛋白-胆固醇血症的检出率越高,高血压、高血糖、高尿酸血症的检出率亦越高,其组间差异有统计学意义(P<0.01)。结论肥胖是代谢综合征的一个重要临床表现,也是高血压病、冠心病、高脂血症、2型糖尿病等的重要危险因素。     

代谢综合征组分及尿酸与动脉脉搏波传导速度的相关性研究

目的研究代谢综合征组分及尿酸与动脉脉搏波传导速度的相关性。方法选取中南大学湘雅三医院健康管理中心健康体检者7 358例,测定其代谢综合征组分包括腰围、血压、空腹血糖、甘油三酯、高密度脂蛋白胆固醇,并根据代谢综合征组分项目数分为0、1、2、3四个亚组;同时测定血尿酸(uric acid,UA),并根据UA是否异常,将其分为正常UA组和高UA组。应用多功能血管病变诊断仪测定肱踝动脉脉搏波的传导速度(brachial-ankle pulse wave velocity,ba PWV),采用t检验、多重线性回归及方差分析等方法分析与评估代谢综合征组分和UA与ba PWV的关系。结果 1ba PWV与收缩压、舒张压、空腹血糖、UA、腰围均具有相关性,对ba PWV的贡献大小依次为收缩压舒张压空腹血糖UA腰围。2ba PWV及UA值均随代谢综合征的组分增多而呈阶梯样增加。3高UA组的ba PWV明显高于正常UA组,高UA组中女性的ba PWV明显高于男性,MS组的ba PWV明显高于非MS组,且MS及UA对动脉僵硬度的影响在女性中均比在男性中更明显。4非MS组中高UA对ba PWV的影响比MS组中UA对ba PWV的影响更加明显。结论性别、MS及UA与ba PWV具有密切关系,高UA可能是影响动脉僵硬度的独立危险因素,因此,在今后的临床实践中联合检测MS各组分、UA与ba PWV,对预测、评估及防治MS和早期动脉硬化具有重要意义。     

儿童超重及肥胖与代谢综合征的相关性

目的 探讨儿童超重与代谢综合征(MS)的相关性.方法 回顾性调查分析某院2002年1月～2011年12月期间在门诊就诊的肥胖儿及超重儿为研究对象,按照体重指数分组分为超重儿174例、肥胖儿154例.同时以同期住院治疗体重指数正常的仅仅患呼吸道疾病患儿325例为对照组.分析腰围、臀围、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、空腹胰岛素(FINS)及计算胰岛素抵抗指数(HOMA-IR).结果 (1)对照组MS患病率0.00％,超重儿MS患病率6.90％,肥胖儿MS患病率25.32％,随着体重指数的升高,MS患病率呈现升高趋势,三组MS患病率比较差异有统计学意义(x2=93.35,P＜ 0.01). (2)腰围、臀围、SBP、DBP、FBG、TC、TG、HDL-C、LDL-C、ALT、AST、FINS、HOMA-IR等检测指标结果在对照组、超重儿、肥胖儿中以逐渐升高趋势分布,并且超重儿与对照组、肥胖儿与对照组组间各指标比较差异均有统计学意义(P＜0.05). (3) BMI、腰围、SBP、TC、TG、LDL-C、ALT、AST、FINS与HOMA-IR呈正相关,HDL-C与HOMA-IR呈负相关(均P＜0.01).结论 超重及肥胖儿童MS发病率明显较正常体重儿童升高,MS发病与超重及肥胖密切相关,应注重预防超重及肥胖.     

体检人群超重／肥胖与代谢综合征的关系

代谢综合征（metabolic syndrome，MS）是多种代谢危险因素在个体内的聚集，其中包括肥胖、血脂紊乱、高血压、糖尿病等多种代谢紊乱。超重／肥胖是指由多种原因引起的脂肪成分过多且超过正常人平均量的病理状态。肥胖不仅本身是一种疾病，而且是血脂异常、高血压、2型糖尿病、心血管疾病（CVD）的重要危险因素。血脂异常产生游离脂肪酸（FFA）升高是MS引起胰岛素抵抗（IR）的重要因素。     

某校大学生不同肥胖类型与心血管疾病代谢指标的关系

目的  获得大学生不同肥胖类型与心血管疾病代谢指标之间的关联性,为有效控制青少年肥胖、预防心血管疾病提供科学依据。 方法  本次研究以芜湖市某高校2018级3 450名新生为研究对象,采用整群抽样的方法对其进行问卷调查和体格检测。使用BMI及腰围身高比(waist height ratio, WHtR)作为判断肥胖的指标。 结果  符合条件的3 349名调查对象中复合型肥胖、中心型肥胖和外周型肥胖的患病率分别为6.51%、4.93%、0.53%。除了载脂蛋白A(apolipoprotein A, APOA)外,各心血管疾病代谢异常检出率在不同肥胖类型之间差异均有统计学意义(均有P＜0.05)。除APOA外,复合型肥胖发生心血管疾病代谢异常的风险较非肥胖人群均有增加(均有P＜0.05)。与非肥胖人群相比,复合型肥胖的青少年出现指标异常数≥2的可能性是6.86倍(OR=6.86, 95% CI: 4.54~10.39)。 结论  复合型肥胖青少年发生心血管疾病代谢异常的风险较高,联合使用BMI和WHtR可提高对青少年心血管疾病的预测效应。     

Different degree of intervention in 6-month weight-loss support and arterial stiffness: Secondary analysis of a randomized controlled trial

Background and aimsWeight reduction by lifestyle modification (i.e., low-calorie diet and/or exercise) decreases arterial stiffness in overweight or obese individuals. We previously demonstrated that weight loss differs depending on the degree of intervention in weight-loss support in a randomized controlled trial (UMIN000001259). However, the effect of different degrees of intervention on arterial stiffness remains unclear.Methods and resultsA total of 188 middle-aged men and women with overweight or obesity (51 ± 7 years, BMI: 29.0 ± 3.2 kg/m²) participated in the 6-month trial wherein they were assigned to a low (LI, n = 63), moderate (MI, n = 62), or high intensive intervention (HI, n = 63) group. Initially, one motivational lecture on weight loss was provided to all three groups, whereas educational materials (textbooks, notebooks, and a pedometer) were provided to groups MI and HI. Additionally, the HI group participated in a series of group-based sessions. Body weight and arterial stiffness assessed by brachial-ankle pulse wave velocity (baPWV) were measured at 0, 3, and 6 months. Six-month weight loss was greater in the order of HI, MI, and LI groups. The interventions reduced baPWV in all groups, and the reduction was not significantly different among the groups (114.3 ± 16.3, 82.6 ± 15.2, and 98.8 ± 90.4 cm/s, respectively).ConclusionIn overweight or obese individuals, different degrees of intervention in weight-loss support affect body weight; however, the extent to which arterial stiffness improves does not differ among support programs.     

The effect of metformin on cardiovascular markers in female mice consuming a high fat diet

BackgroundMetformin, widely used to treat diabetes, is now considered a candidate therapeutic for treatment of cardiovascular disease. This study aimed to assess whether metformin’s non-glycaemic effects could mitigate cardiovascular disease indices in female mice consuming a high fat diet (HFD).MethodsFour-week old female Arc:Arc(S) mice were placed on a standard (std) chow diet or Western-style HFD (22% fat, 0.15% cholesterol). At ～8 months, the mice were administered 150 mg/kg metformin or vehicle (control) via intraperitoneal injection for 11 days. Blood pressure was measured (tail cuff plethysmography) at Day 9 and 11 of treatment. On Day 11, mice were weighed and culled. The mesenteric arcade and kidneys were collected for assessment of vascular reactivity (wire myography), and assessment of expression of cardiometabolic markers (qPCR), respectively.ResultsThe HFD fed female mice were significantly heavier than those receiving the std diet at 1–12 weeks on diet, and at cull. Mice on a std diet with metformin treatment were significantly heavier at cull than the mice on a std diet administered the control treatment. Metformin treatment did not alter the weight of the mice receiving the HFD. Neither the HFD (compared to the std diet), nor metformin treatment (compared to control treatment) altered blood pressure, vascular reactivity, or expression of cardiometabolic markers in the kidney.ConclusionConsumption of a Western-style HFD (without high salt/sugar levels) did not alter the cardiovascular markers measured. Further studies are required to establish the non-glycaemic, cardio-protective effects of metformin in high-risk cohorts.     

Relations of cardiovascular risk factors to aortic pulse wave velocity in asymptomatic middle-aged women

Cross-sectional associations between aortic elasticity assessed by carotid to femoral pulse wave velocity (PWV) and cardiovascular risk factors were examined in 429 apparently healthy middle-aged women. PWV was strongly and positively related to blood pressure and hypertension. Weak but significant positive associations were also found between PWV and age, heart rate, some lipids and lipoproteins, blood glucose (either as a continuous or dichotomous variable), body mass index, haematocrit, leucocyte count and family history of diabetes. No associations were observed between PWV and high density lipoprotein cholesterol, apolipoprotein Al, fibrinogen, cigarette smoking, menopausal status and a family history of hypertension or myocardial infarction. After adjustment for systolic blood pressure, PWV remained significantly related to heart rate, leucocyte count, blood glucose (as a dichotomous variable) and a family history of diabetes. Multiple regression analysis showed that systolic blood pressure and, to a lesser extent, heart rate, leucocyte count and a family history of diabetes were all independent determinants of PWV. This pattern of associations suggests that arterial stiffness measured by PWV reflects the sclerotic rather than the atherotic component of atherosclerosis. The potential influence of a family history of diabetes on the elastic properties of the aorta needs to be ascertained in further studies.     

Inflammation as a cardiovascular risk factor and pulse wave velocity as a marker of early-stage atherosclerosis in the Japanese population

Inflammation and pulse wave velocity (PWV) are a potential risk factor and marker, respectively, for atherosclerosis in the primary prevention setting. Atherosclerosis is now generally accepted to be an inflammatory disorder of the arterial wall, and the high-sensitivity C-reactive protein (hs-CRP) level has been reported to be a strong predictor of cardiovascular events. High-sensitivity-CRP is associated with two factors related to inflammation: (1) the local production of CRP by atheromatous tissue or coronary artery smooth muscle cells and (2) adipose tissue as a potent source of inflammatory cytokines. Based on studies in North America and Europe, hs-CRP has been established as a cardiovascular risk factor and a cut-off value has been recommended. However, Japanese have lower hs-CRP values than their Western counterparts, partly because Japanese have a lower body mass index (BMI), which correlates positively to hs-CRP, and partly because lifestyle and genetic factors can affect hs-CRP values. Therefore, a cut-off value needs to be established by cohort studies for the Japanese population. Carotid-femoral PWV is most commonly measured by applanation tonometry, particularly in Europe, but this method is critically dependent upon the accurate placing of transducers over the arteries and is both time-consuming and complex. A novel device has been recently developed in Japan that measures brachial-ankle PWV (baPWV) using a volume-rendering method. Brachian-ankle PWV is a suitable screening method because of its technical simplicity and shorter measurement time. It is associated not only with conventional cardiovascular risk factors but also with new risk factors, such as inflammation, γ-glutamyltransferase, chronic kidney disease, and psychosocial factors. However, a suitable cut-off value has yet to be established.     

南宁地区儿童青少年肥胖与代谢综合征相关性的流行病学研究

目的 分析儿童青少年肥胖与代谢综合征(MS)相关性及危险因素.方法 采用分层整群随机抽样方法从南宁市396所中小学抽取14所学校6～18岁中小学生7893人,进行体格检查及空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、空腹胰岛素(FINS)的血液生化检测,并计算胰岛素抵抗指数(HOMA-IR).结果 (1)MS患病率为正常组0.57％、超重组4.53％、肥胖组26.80％.(2)除HDL-C均值随肥胖增加而降低外,其余各指标均值、异常率比较均为肥胖组＞超重组＞正常组,3组间差异有统计学意义(P＜0.05).(3)对MS有影响的指标为腰围(OR=1.087,95％CI:1.033～1.143)、SBP(OR=1.073,95％CI:1.032 ～ 1.1 16)、FBG(OR=1.394,95％CI:1.568 ～3.423)、TG(OR=3.213,95％CI:1.410 ～ 7.319)、HDL-C(OR=0.001,95％ CI:0.000～0.012).结论 儿童青少年MS与肥胖密切相关,其患病率和危险因素随着肥胖程度的加重而增加.     

Metabolic syndrome and metabolically healthy status in adults with overweight or obesity,expressing no desire to lose weight

AimTo examine the prevalence of metabolic syndrome (MetS) and metabolically healthy status (MHS) in adults with excess weight, who express no desire to lose weight (DLW).MethodsWe used the National Health and Nutrition Examination Survey (2011–2016) to conduct a cross-sectional analysis of 4509 adults with excess weight. The prevalence of MetS and MHS was estimated by a DLW status. The prevalence ratios (PRs) were estimated, adjusting for demographic characteristics, to compare the prevalence of MetS and MHS between those with and without a DLW.ResultsAmong adults who were overweight, the crude prevalence of MetS was 28.9% (95% CI 23.7, 34.1) in the no-DLW group and 36.0% (95% CI 31.9, 40.0) in the DLW group (adjusted PR 0.88; 95% CI 0.70, 1.11). Among adults with obesity, the crude prevalence of MetS was 60.0% (95% CI 52.3, 67.6) in the no-DLW group and 63.2% (95% CI 60.0, 66.4) in the DLW group (adjusted PR 1.00; 95% CI 0.88, 1.14). Among adults who were overweight, the prevalence of MHS was 17.5% (95% CI 13.4, 22.2) in the no-DLW group, and 9.5% (95% CI 7.6, 11.6) in the DLW group (adjusted PR 1.27; 95% CI 0.96, 1.69). Nearly all adults with obesity had at least one component of MetS regardless of DSW status.ConclusionsOne in four overweight adults and three in five obese adults without a DLW had MetS in the U.S. A majority of adults who were overweight or obese without a DSW had at least one component of MetS.     

The impact of obesity on cardiovascular disease mortality in the District Sumperk,Czech Republic

Summary Objective: The impact of obesity on cardiovascular mortality in the District Sumperk (C2) is assessed. Methods: A case-control design was selected to study the impact of obesity on cardiovascular mortality among the population of the District Sumperk, Czech Republic. Exposure to obesity was defined as body-mass index (BMI) higher or equal 30. Men and women with BMI lower than 30 were considered nonexposed. Odds ratios were calculated, comparing the probability of exposure among cases and controls. Cases were defined as persons from the studied population who died between 1987–2004, the cause of death being circulatory system diseases. Controls were persons from the studied population who had not died as to December 31, 2004. Results: Cases were more likely to be obese than controls (OR = 1.68; 95 % CI 1.56–1.80). In men OR was 1.56 (95 % CI 1.40–1.74), in women OR was 1.89 (95 % CI 1.72–2.06). The impact of obesity was decreasing with increasing age. Conclusions: An increased risk of cardiovascular mortality following exposure to obesity was observed. Younger age groups seem to be the important target population for preventive programmes focusing on treatment of obesity. Submitted: 6 June 2006; Revised: 9 March 2007; Accepted: 29 March 2007