踝-臂血压指数与传统心血管病危险因素关系的探讨

目的探讨踝臂血压指数ABI作为新的危险因素预测指标与传统心血管病危险因素间的关系。方法病例对照研究方法。结果Logistic回归分析表明年龄、高血压、糖尿病、吸烟为低ABI(ABI<0.9)的主要影响因素。其中男性ABI异常的相关危险因素有年龄、血糖值、血压值、吸烟率;女性ABI异常的相关危险因素有年龄、血糖值、吸烟率。结论ABI与其他心血管病危险因素间存在聚集关系。ABI与年龄、高血压、糖尿病、吸烟等相关;ABI值降低增加心血管病的发病危险。     

健康体检1084例踝臂指数与心血管危险因素关系的分析

目的了解踝臂指数（ABI）与心血管疾病各相关因素之间的关系。方法对1084例门诊体检人群,检测空腹血糖、血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、体重指数、收缩压、舒张压,并计算不同性别、不同ABI分组条件下各组的患病率。结果男性和女性在不同ABI组中的分布不相同（x^2=52．130,P〈0．05）。按ABI分组,心血管各危险因素中年龄、体重指数、收缩压、舒张压、总胆固醇、三酰甘油及空腹血糖在三组中比较,差异有统计学意义（F值分别为28．268、24．826、192．950、88．213、7．602、14．802、199．216,P〈0．05）。其中年龄、血压及空腹血糖随着ABI的减低而逐渐增加。随着ABI分级的增加,同时并存多个危险因素的例数逐渐增加。结论ABI是预测心血管疾病的重要因子,有利于心血管疾病的发现和监控。     

北京某社区55岁以上居民踝臂血压指数变化与心血管病相关危险因素

目的 分析北京广外社区55岁以上居民踝臂血压指数变化与心血管病相关危险因素关系.方法 选取2014-2015年“十二五”国家科技支撑计划项目广外社区协作组55岁以上361例人群资料,通过问卷调查了解人群基本情况、家族史、生活方式及行为相关危险因素;体格检查收集调查对象的身高、体重、腰围、血压,踝臂血压、身体脂肪率,利用SPSS 19.0软件包进行统计分析.结果 ①调查人群踝臂血压指数(ABI)均值为(1.22±0.11),其中男性水平(1.26±0.11)和女性ABI值(1.21±0.11)之间差异无统计学意义(P =0.306);②方差分析比较各年龄组之间ABI值的差异显著(P＜0.05);③高血压组ABI值(1.21±0.10)与非高血压组ABI值(1.24±0.11)相比,两组差异具有统计学意义(P =0.033).对生活方式和行为、家族史等因素进行Logistic回归分析得出:BMI、年龄、身体脂肪率、高血压家族史是影响ABI变化的主要影响因素.结论 随着年龄增长,ABI值逐渐下降,高血压、年龄、体质指数、身体脂肪率和家族高血压病史是踝臂血压指数异常的重要影响因素.通过对踝臂指数的监测,可以有针对性开展高危人群心血管疾病早期评估和干预.     

踝臂血压差值与高龄老人心血管疾病的相关性研究

目的探讨四肢血压差值,尤其是踝臂血压差值与高龄老年人心血管疾病的相关性.方法采用四肢血压同步测试仪,将72例80岁以上的高龄老年人按健康与心血管疾病分为5组,用健康组分别与高血压并脑卒中、高血压动脉硬化、冠心病、糖脂代谢紊乱组比较,观察踝臂血压差值与上述四类疾病的相关性.结果踝臂血压差值与高血压并脑卒中呈负相关;与高血压动脉硬化呈正相关;与冠心病部分相关;与糖脂代谢紊乱无显著相关.结论四肢血压同步测试可作为观察高龄老年人心血管功能状况的一项检测方法,此法方便、快捷、无创,值得推广.     

踝臂血压差值与高龄老人心血管疾病的相关性研究

目的：探讨四肢血压差值，尤其是踝臂血压差值与高龄老年人心血管疾病的相关性。方法：采用四肢血压同步测试仪，将72例80岁以上的高龄老年人按健康与心血管疾病分为5组，用健康组分别与高血压并脑卒中、高血压动脉硬化、冠心病、糖脂代谢紊乱组比较，观察踝臂血压差值与上述四类疾病的相关性。结果：踝臂血压差值与高血压并脑卒中呈负相关；与高血压动脉硬化呈正相关；与冠心病部分相关；与糖脂代谢紊乱无显相关。结论：四肢血压同步测试可作为观察高龄老年人心血管功能状况的一项检测方法，此法方便、快捷、无创，值得推广。     

居民踝臂指数水平调查

目的 调查衢州市城乡30岁以上居民踝臂指数水平.方法 采取分层整群抽样方法,抽取衢州市城区、郊区和农村3个街道（乡镇）6个行政村1800名30岁以上居民,测量踝臂指数（ABI）、血糖和血脂等血生化指标并进行体格检查和问卷调查.结果 本次调查衢州市30岁以上居民中,低ABI检出率为12.72%;随年龄增加,低ABI发生率升高.正常组人群外周动脉疾病（PAD）发生率为10.24%,慢性病（高血压、糖尿病、高血脂）人群PAD发生率为14.45%,两组差异有统计学意义（P〈0.05）.慢性病人不同性别低ABI发生率无差异.结论 通过对30岁以上合并慢性病的人群进行ABI筛查,可以及早发现PAD,也可作为心血管疾病的一个预测指标.     

中老年机关干部体质指数与其他心血管危险因素聚集的关系

目的探讨中老年机关干部体质指数（BMI）与其他心血管危险因素聚集的关系。方法选用1 477名机关干部健康体检资料（年龄40~84岁）,分析不同BMI组高血压、糖尿病、高胆固醇（TC）、高甘油三酯（TG）和低高密度脂蛋白胆固醇（HDL-C）的聚集情况和相对危险,对危险因素聚集率与BMI进行相关分析。结果男性和女性机关干部其他心血管危险因素的聚集率分别为42.23%、29.21%。随着BMI的增加,其他危险因素的聚集率呈明显升高趋势,男性和女性的危险因素聚集率均与BMI呈直线正相关（r=0.996 5/0.999 2）,回归方程^Y=-0.868 5＋0.051 0X/-0.848 0＋0.045 4X。结论中老年干部心血管病危险因素的聚集率与BMI呈直线正相关。控制超重和肥胖对降低中老年干部心血管病危险因素水平具有非常重要的意义。     

甘油三酯葡萄糖乘积指数与心血管疾病危险因素聚集关系的研究

目的 探讨成年人甘油三酯葡萄糖乘积（triglyceride-glucose index,TyG）指数与心血管疾病危险因素聚集的关系。方法 采用随机抽样的方法,调查安徽省蚌埠市龙子湖区居民,共1 777名,调查内容主要包括问卷调查,身体指标测量和实验室检查。将TyG指数按四分位数分组,使用Logistic多因素回归分析TyG指数与心血管疾病危险因素聚集的关系。通过受试者工作特征（receiver operator characteristic curve,ROC）曲线分析,计算TyG指数判断心血管疾病危险因素聚集的临界值及作用大小,并与其余指标进行比较。结果 调查人群男性748人（42.09%）,女性1 029人（57.91%）。平均年龄为（60.82±11.24）岁。Spearman相关分析表明TyG指数与心血管疾病危险因素均存在相关性（均有P<0.001）。Logistic多因素分析显示,TyG指数是心血管疾病危险因素聚集的危险因素（OR=2.930,95% CI：2.625~3.272）。TyG指数为8.78时,判断心血管疾病危险因素聚集的约登指数最大。其ROC曲线下面积与空腹血糖、甘油三酯、身高体重指数（body mass index,BMI）的相比差异均有统计学意义（均有P<0.05）,而与腰围身高比（waist-to-height ratio,WHtR）的差异无统计学意义（Z=0.117,P=0.907）。结论 TyG指数与心血管危险因素聚集密切相关,可做为识别心血管疾病危险因素聚集的简单工具。     

踝臂指数、颈动脉粥样硬化与缺血性脑梗死相关性的临床分析

目的 了解踝臂指数（ABI）、颈动脉粥样硬化与缺血性脑梗死的相关性,探讨与缺血性脑梗死有关的危险因素.方法 随机选择自2009年2月～2009年6月在神经内科就诊的脑梗死患者100例作为实验组;同时选取在此期间于笔者所在医院门诊体检的80例非脑梗死患者作为对照组.两组均使用多普勒超声仪测量ABI,彩色多普勒超声诊断仪检测双侧颈动脉硬化情况.采用SPSS 16.0软件包处理数据进行分析.结果 实验组的踝臂指数、颈动脉硬化斑块与对照组比较,差异有统计学意义（P〈0.05）.结论 在相同年龄组,ABI降低、颈动脉硬化斑块形成是缺血性脑梗死的易患因素.     

高尿酸血症与心血管危险因素的关系

目的 探讨高尿酸血症与心血管危险因素的相关性.方法 以体检人群中发现高尿酸血症患者182人为实验组,尿酸正常的182人为对照组,测量两组BMI、血压、空腹血糖、血清总胆固醇、甘油三脂、高密度脂蛋白胆固醇等心血管病(CVD)危险因素并进行比较.结果 高尿酸血症的BMI、血压、空腹血糖、胆固醇、甘油三脂水平高于对照组,高密度脂蛋白胆固醇低于对照组,均有显著差异(P<0.05);实验组高血压、超重肥胖、血脂异常等心血管危险因素具有明显聚集性,与正常组比较有显著差异(P相似文献   

糖尿病患者尿蛋白及踝肱指数异常的相关性分析

目的了解糖尿病肾病（DKD）与下肢动脉病变（PAD）的关系及相关因素。方法分析了4031例2型糖尿病患者的临床资料,将患者分为正常蛋白尿、微量蛋白尿和临床蛋白尿组,并根据踝肱动脉压指数（ABI）分为正常组与异常组,统计各组中尿蛋白和ABI的异常率,采用Logistic回归方法分析PAD与DKD相关性及其影响因素。结果全组患者中尿蛋白异常率26．35％,ABI异常率17．73％;异常组与正常组相比,年龄大,病程长,糖化血红蛋白（HbAIC）高,血压高,脉压差大。正常蛋白尿、微量蛋白尿和临床蛋白尿组的ABI异常率分别为14．55％,21．92％和28．42％;ABI正常和ABI≤0．9、ABI〉1．3的患者DKD患病率分别为23．79％,41．43％,30．60％;多因素分析发现,年龄、性别、尿蛋白异常、体质指数（BMI）、立位收缩压、立位舒张压、空腹血糖、总蛋白（TP）、血清白蛋白（AIB）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、肌酐（Cr）是PAD的独立危险因素;年龄、病程、ABI异常、BMI、卧位收缩压、卧位舒张压、餐后血糖、HbA。白蛋白、白蛋白／球蛋白（MG）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL—C）,Cr、尿素氮（BUN）是DKD的主要危险因素。结论糖尿病肾病与下肢动脉病变密切相关,可相互促进病情发展。     

Development of a Diet Index for Older Adults and Its Relation to Cardiovascular Disease Risk Factors: The Elderly Dietary Index

Objective

To develop an index that assesses the degree of adherence to nutritional recommendations for older adults (Elderly Dietary Index [EDI]) and investigate its association with risk factors related to cardiovascular disease (CVD).

Methods

The EDI was constructed using 10 components (ie, questions about the consumption frequency of meat, fish, fruits, vegetables, grains, legumes, olive oil, and alcohol as well as the type of bread and dairy products) according to the Modified MyPyramid for Older Adults and select features of the traditional Mediterranean diet. Scores from 1 to 4 were assigned to all components of the index. The EDI total score had a range between 10 and 40. As a validation procedure, a sample of 668 elderly individuals without known CVD (the MEDIS Study) was used to evaluate the associations between the proposed index and various health outcomes.

Results

The overall mean EDI score was 29.2±3.5. This score implies that study participants were 73% (ie, 29.2/40) adherent to the nutritional recommendations that the EDI evaluates. Regarding the conventional CVD risk factors, it was found that a 1 unit increase in the EDI score is associated with almost 10% lower odds of being obese or hypertensive or having at least one of the investigated CVD risk factors (P<0.001) after controlling for potential confounders.

Conclusions

The suggested EDI may be a useful tool for public health policymakers and other health care professionals to assess diet quality and health status (especially concerning the risk for developing CVD) in older adults.     

2型糖尿病患者踝臂指数与糖尿病肾病的关系研究

目的 探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者踝臂指数(ABI)与糖尿病肾病(diabetic kidney disease,DKD)之间的关系. 方法 485例T2DM患者及56例健康体检者为研究对象.根据24 h尿白蛋白定量将T2DM患者分为正常尿白蛋白组(尿白蛋白＜30 mg)、微量尿白蛋白组(尿白蛋白30～300 mg)和临床尿白蛋白组(尿白蛋白＞300mg).观察各组之间踝臂指数的差异,探讨踝臂指数与糖尿病肾病的关系. 结果 T2DM患者踝臂指数高于正常对照组(P＜0.05).T2DM患者中,微量尿白蛋白组的ABI较正常尿白蛋白组高(P＜0.05),大量尿白蛋白组的ABI高于其他两组(P＜0.01).尿白蛋白与ABI相关性分析显示尿白蛋白与ABI呈负相关(r=- 0.216,P＜0.01).糖尿病肾病患者的肾小球滤过率与ABI亦呈负相关(r=-0.529,P＜0.05). 结论 ABI对糖尿病肾病有很好的早期预测价值,且与糖尿病肾病严重程度相关.     

Community-Level Cardiovascular Risk Factors Impact Geographic Variation in Cardiovascular Disease Hospitalizations for Women

Prior work has shown significant geographic variation in cardiovascular (CV) risk factors including metabolic syndrome, obesity, and hypercholesterolemia. However, little is known about how variations in CV risk impact cardiovascular disease (CVD)-related hospitalizations. Community-level CV risk factors (hypertension, dyslipidemia, hyperglycemia, and elevated waist circumference) were assessed from community-wide health screenings sponsored by Sister to Sister (STS) from 2008 to 2009 in 17 major US cities. Using data from the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample (HCUP-NIS), CVD hospitalizations were identified based on ICD-9 codes for acute myocardial infarction (AMI), congestive heart failure (CHF), and stroke. We linked STS data with HCUP-NIS hospitalizations based on common cities and restricted the analysis to women discharged from hospitals inside the STS cities. Using hierarchical models with city as the random intercept, we assessed the impact of city-specific CV risk factors on between-city variance of AMI, CHF, and stroke. Analyses were also adjusted for patient age and clinical comorbidities. Our analysis yielded a total of 742,445 all-cause discharges across 70 hospitals inside of 13 linked cities. The overall city-specific range proportion of AMI, CHF, and stroke hospitalizations were 1.13 % (0.75–1.59 %), 2.57 % (1.44–3.92 %), and 1.24 % (0.66–1.84 %), respectively. After adjusting for city-specific CV risk factors, between-city variation was no longer statistically significant for all CVD conditions explored. In conclusion, we found that geographic variations in AMI, CHF, and stroke hospitalizations for women may be partially explained by community-level CV risk factors. This finding suggests that interventions to reduce CVD should be tailored to the unique risk profile and needs of high-risk communities.     

老年离退休人群血浆Hcy水平检测及与心血管疾病传统危险因素的相关分析

目的：探讨某地区离退休人群血浆中同型半胱氨酸（Hcy）水平的变化,探讨高Hcy血症与心血管疾病传统危险因素的关系,为老年人群健康体检预防心血管疾病提供理论依据和指导。方法：收集2013年十堰市地区东风公司离退休职工2200例血浆Hcy检测结果,按年龄与性别做分组统计。选取高Hcy血症人群分为高血压组、心电图异常改变组、吸烟组、高脂血症组、高血糖组。结果：本次老年体检人群高Hcy血症312例,占本次体检人群的14.18%,不同年龄组不同性别间的Hcy水平比较差异无统计学意义（P＆gt;0.05）;高血压组、心电图异常改变组、高脂血症组、高血糖组Hcy平均水平均高于健康对照组,差异有统计学意义（P＆lt;0.05）;高Hcy血症在高血压组发生率最高,其次为心电图异常改变组。结论：老年人群中高Hcy血症与心血管传统危险因素呈正相关,在健康体检中定期检测Hcy,对干预治疗老年人群心血管疾病有积极作用。     

Fat Quality Index and Risk of Cardiovascular Disease in the Sun Project

Objectives

To examine the association between a dietary fat quality index (FQI), and the risk of incident cardiovascular events or deaths in the Seguimiento Universidad de Navarra (SUN) cohort.

Design

Longitudinal analysis during 10.1 years of median follow-up. Cox models were used to estimate adjusted hazard ratios (HR) of incident cardiovascular diseases (CVD) according to tertiles of FQI and of different fat subtypes.

Setting

University of Navarra, Spain.

Participants

19,341 middle-aged adults.

Measurements

Fat intake was measured with a validated food-frequency questionnaire. The FQI was calculated according to the ratio: (monounsaturated+polyunsaturated) / (saturated+trans fatty acids).

Results

We observed 140 incident cases of CVD. No association was found for FQI (HR=0.94, 95 %CI 0.61–1.47 for the highest vs the lowest tertile, p for trend=0.884). No significant associations were found for different dietary fat subtypes on CVD risk. The results suggest no clear association between a higher FQI and a higher amount of energy from fat and incidence of CVD (p for interaction: 0.259 and p for trend only among participants with a percentage of energy from fat ≥35% of total energy: 0.272).

Conclusion

In this Mediterranean cohort, the FQI was not associated with cardiovascular events. A “heart-healthy diet” should focus its attention on dietary fat sources and should use an overall dietary pattern approach, rather than limiting the focus on fat subtypes. More research is needed to validate dietary advice on specific fatty acids intake or saturated fatty acids replacements for reducing CVD risk.

     

广州市中年人群体力活动与其他心血管病危险因素关系的研究

目的 了解广州市城乡中年人群的体力活动状况及其与心血管病主要危险因素的关系。方法 采用整群随机抽样方法调查广州市35－59岁城市居民1124人及农村居民1029人，按照国家“九五”攻关课题（编号96－906－02－01）统一方案、采用标准化方法进行。结果 农村人群中等强度及以上的体力活动时间平均占全天的20．7％，明显高于城市人群（7．2％）；农村人民不活动或少活动的时间占全天的60．5％，较城市人群（73．7％）少。农村人群高胆固醇现患率、高密度脂蛋白胆固醇降低率、高血糖现患率和超重率均低于城市人群，但吸烟率和饮酒率明显高于城市人群。多元线性回归分析显示，不活动和少活动时间对血压升高、血中胆固醇升高、高密度脂蛋白胆固醇降低及体重增加的影响均有非常显性意义。结论 缺乏体力活动会使心血管病危险因素有增加的趋势。     

Impact of Treatment for Childhood Obesity on Parental Risk Factors for Cardiovascular Disease

Background. Family-based approaches using the parents as agents of change to treat childhood obesity are superior to programs targeting only children in achieving weight reduction and have a lower dropout rate.Objective. The aim of this study was to compare the impact of two behavioral approaches (parents only vs children only) for the treatment of childhood obesity on parental weight, eating, and activity habits as well as cardiovascular risk factors.Design. A randomized 1-year clinical intervention study was performed.Methods. Sixty obese children (≥20% over ideal weight for age, height, and sex), ages 6–11 years, were randomly allocated to the experimental (parents as sole agents of change) or conventional groups (children as sole agents of change). Fourteen (1-h-long) support/educational sessions were conducted by a clinical dietitian for the parents in the experimental group and 30 sessions for children in the conventional group. Anthropometric and biochemical measurements were determined at the start and end of the program.Results. The experimental approach, when compared to the conventional intervention, was found to be superior in the reduction of fathers overweight (P < 0.05). The former approach resulted also in improved profile of risk factors for cardiovascular disease in both parents. These changes could be ascribed to a greater improvement in eating and activity behaviors observed in parents belonging to the experimental intervention group who participated in a family-based intervention to treat their children's obesity.Conclusions. Treatment of childhood obesity targeting the parents as the sole agent of change, which is more effective for the treatment of childhood obesity when compared to a children-oriented program, may in addition award parents with the benefit of changing their own eating and activity patterns, thus making this program ideal for treatment of obesity in children and their overweight parents.