代谢综合征各危险因素与不同节段脉搏波速度的相关性分析

目的横断面调查北京社区代谢综合征人群不同节段脉搏波速度变化及其相关因素分析。方法北京3个大型社区成年健康体检人群,测定颈股、颈桡、颈踝脉搏波速度(cfPWV、crPWV、caPWV),同时采集身高、体质量、腰围、臀围、血压、血糖、血脂、血尿酸、肌酐等指标,并按国际糖尿病联盟诊断标准将人群分为代谢综合征及非代谢综合征组。结果共计2439名18~92岁社区居民完成所有调查,其中代谢综合征732例,占30.01%。两组相比,代谢综合征人群平均年龄较大[(53.3±13.7)比(50.0±15.7)岁,P0.01],cfPWV、caPWV和crPWV均明显增快[(11.68±2.92)m/s比(10.24±2.43)m/s,(9.46±1.73)m/s比(8.76±2.23)m/s,(9.76±1.52)m/s比(9.42±1.45)m/s,均P0.01],心血管疾病发病率亦显著增加(18.3%比9.1%,P0.01)。经校正年龄、性别后,偏相关分析显示,脉压、低密度脂蛋白胆固醇、尿酸和代谢综合征诸组成,均与cfPWV和caPWV呈相关关系(P均0.05);逐步回归分析显示,代谢综合征是三段PWV增加的独立危险因素;进一步分析发现,代谢综合征各组成对不同节段PWV影响不同,其中,腹型肥胖仅对cfPWV有影响;收缩压和血糖增高是cfPWV和caPWV的独立危险因素;仅舒张压对crPWV升高有显著影响;血三酰甘油、高密度脂蛋白胆固醇水平对三段PWV均无独立影响。结论代谢综合征是动脉硬化的独立危险因素,其中中心性肥胖、高血压、糖代谢异常是影响动脉硬化的主要原因。

The correlation of metabolic syndrome factors and pulse wave velocity

Objective A cross-sectional was conducted to investigate the correlation of pulse wave velocity （PWV）and metabolic syndrome （MS）factors.Methods All the adult participants in this cross-sectional investigation were recruited from 3 big communities during their annual physical examination.Regional arterial stiffness was assessed simultaneously by measuring PWV in three arterial segments,carotid -femoral （cfPWV）,carotid -radial （crPWV）and carotid-ankle PWV （caPWV）.Demographic characteristics and basal biochemical parameters including height,weight,waist and hip circumference,blood pressure,and serum levels of glucose,lipid,uric acid and creatinine were collected.MS was identified according to the criteria from the International Diabetes Federation definition.Results A total of 2439 citizens （aged 18 to 92 years）were enrolled into this study,which included 732 participants with MS （prevalence,30.01%）.The subjects with MS were older[（53.25 ±13.73）vs.（50.03 ±15.73）, P〈0.01],and had a higher cfPWV,caPWV,crPWV（11.68 ±2.92）m/s vs.（10.24 ±2.43）m/s,（9.46 ±1.73） m/s vs.（8.76 ±2.23）m/s,（9.76 ±1.52）m/s vs.（9.42 ±1.45）m/s,P〈0.01 for all],and an increased incidence of cardiovascular diseases （18.3% vs.9.1%,P〈0.001）.Partial correlation analysis after adjustment for age and sex showed that pulse pressure,LDL-C,uric acid and all component of MS were significantly correlated to the values of cfPWV and caPWV （P〈0.05 for all）.The results of multivariate stepwise linear regression analysis indicated that MS was an independent risk factor for the cfPWV,cfPWV and caPWV.Further analysis showed that increased systolicblood pressure and hyperglycemia were the independent risk factors for cfPWV and caPWV ,and the diastolic blood pressure for crPWV.Central obesity was correlated with enhanced cfPWV,while no correlation was observed between the level of serum triglyceride,high density lipoprotein and PWV.Conclusion MS is the independent risk factor for the arteriosclerosis,of which central obesity,hypertension and hyperglycemia are the major contributor to increased arteriosclerotic risk.