女性冠状动脉粥样硬化与代谢综合征的相关研究

目的:探讨女性动脉粥样硬化(As)发病与代谢综合征、血管内皮功能的关系。方法:有完整的临床和冠状动脉造影资料以及无严重的肝肾和甲状腺疾病的女性参与本研究。根据冠状动脉造影结果,将其分为轻度As组(n=23)、严重As组(n=26)和对照组(n=20)。分别测定各组的临床资料(如血压、体重指数、家族史以及腰围臀围比值等)、生化指标(如血脂、血糖和胰岛素浓度等)以及血管内皮功能。结果:1.As患者(包括轻度和严重As组)甘油三酯(TG)浓度(2.0±0.5)mmolL和(2.3±0.4)mmolL]高于对照组(1.4±0.4)mmolL],而高密度脂蛋白_胆固醇(HDL_C)则低于对照组;2.As患者餐后胰岛素水平和胰岛素血糖比值显著升高,23的As患者存在代谢综合征;3.轻度和严重As组之间各种血脂水平、血糖以及餐后胰岛素浓度无明显差异,但严重As组平均年龄(60.5±6.9)岁]和绝经人数(76.9%)显著大于轻度As组(51.1±9.3)岁和34.8%];4.轻度As组(7.9%±3.7%)和严重As组(8.7%±3.5%)的血管内皮依赖性的血流介导的舒张显著低于对照组(14.1%±4.7%),而血管内皮非依赖性硝酸甘油介导的舒张与对照组无差异。结论:女性As患者即使在As早期或绝经以前就存在血管内皮功能异常和多种代谢异常。

The relationship between coronary atherosclerosis and metabolic syndrome in female

Objective:To explore the effects of metabolic syndrome and endothelial dysfunction on atherosclerosis(As)lesion in the female.Method:Patients who fulfilled the following criteria were entered into the study:female,without severe liver or kidney and thyroid gland diseases,with integrate clinical and coronary angiographic data.According to coronary angiography,these female patients were classified into three groups:mild As group(n=23),severe As group(n=26) and control group(n=20).The clinical data(such as blood pressure,body mass index,family history and waist/hip ratio)and biochemistry markers(such as various kinds of lipoproteins,blood glucose and insulin level)were analyzed.The endothelium_dependent flow_mediated dilatation(F_MD) and the endothelium_independent nitroglycerin_mediated dilatation(NTG_MD) were evaluated by the brachial ultrasound exam.Result:1. Fasting triglyceride level in patients with mild and severe As group (2.0±0.5)mmol/L and (2.3±0.4)mmol/L] were significantly higher than that of control group (1.4±0.4)mmol/L].HDL_C concentrations in 2 As groups were obviously lower than that of the control.2. The postprandial insulin level and insulin/glucose ratio significantly increased in 2 As groups.About 2/3 of patients with As were complicated with metabolic syndrome.3. The each kinds of lipoproteins and the postprandial insulin level was not different between the cases of mild and severe As,but the patients with severe As were older(60.5±6.9 years) and had more numbers of post_menopause(76.9%) than those in mild As(51.1±9.3) years and 34.8%].4. The endothelium dependent F-MD in mild As group(7.9%±3.7%) and severe As group(8.7%±3.5%) was more significantly decreased than that of controls (14.1%±4.7%).The endothelium independent NTG_MD in the 2 As groups were similar to that of controls.Conclusion:Endothelial dysfunction and metabolic syndrome is associated with As lesion(even early atheroma and pre_menopause)in the female.