基于弗明翰风险评分与血管内皮功能分类的心血管疾病危险因素研究

摘要

Objective This study aimed to characterize the risk factors of cardiovascular disease based on Framingham risk score(FRS) and endothelial function classification in subjects with subclinical status.Methods 752 asymptomatic adults were recruited from Siding town,Rongan county and Anchui township,Rongshui county of Guangxi from August to September 2015.For the participants,the 10-year risk for cardiovascular disease was estimated by FRS and based on the estimated results, they were divided into low to moderate risk FRS group (FRS≤20%) and high FRS group(FRS>20%);vascular endothelial function was assessed by brachial artery flow-mediated dilation (FMD),and according to the assessment results,they were assigned to normal endothelial function group (FMD ≥6%) and impaired endothelial function group (FMD<6%), respectively.Logistic regression models were used to analyze the cardiovascular risk factors of the subjects categorized by the 10-year cardiovascular disease risks and vascular endothelial function,respectively.Results Logistic regression analysis showed that the cardiovascular risk factors for those with high FRS but normal FMD,were male,increased age,smoking,elevated systolic blood pressure,low-density lipoprotein cholesterol and triacylglycerol;male and increased age were risk factors associated with cardiovascular disease in those with low to moderate FRS but impaired FMD;male,increased age,smoking, moderate or light physical activity,elevated systolic blood pressure,total cholesterol and high-density lipoprotein cholesterol, C-reactive protein and fasting blood glucose were risk factors associated with cardiovascular disease for those with high FRS and impaired FMD.Conclusion The cardiovascular risk factors were different for subjects with different characterization in subclinical stage.Therefore,individualized measures should be considered in preventing cardiovascular disease for the characterized subjects during the subclinical stage.%目的 探讨基于弗明翰风险评分(FRS)与血管内皮功能分类的心血管疾病危险因素.方法 于2015年8—9月在广西融安县泗顶镇和融水县安陲乡现场招募752例成年人为研究对象.使用FRS评估研究对象10年内心血管疾病发生风险,将其分为FRS正常(FRS≤20%)和FRS高(FRS>20%)两类;采用肱动脉血流介导的血管舒张功能(FMD)测定血管内皮功能,将其分为血管内皮功能正常(FMD≥6%)和血管内皮功能受损(FMD<6%)两类.采用Logistic回归分析不同FRS与血管内皮功能分组的心血管疾病的危险因素.结果 多因素Logistic逐步回归分析结果显示,男性、年龄大、吸烟、收缩压高、低密度脂蛋白胆固醇(LDL-C)高、三酰甘油(TG)高为FRS高但血管内皮功能正常的危险因素;男性、年龄大是FRS正常但血管内皮功能受损的危险因素;男性、年龄大、吸烟、体力活动水平中低、收缩压高、总胆固醇(TC)高、高密度脂蛋白胆固醇(HDL-C)低、C反应蛋白(CRP)高、空腹血糖高是FRS高和血管内皮功能受损的危险因素.结论 不同心血管疾病群体的危险因素存在差异,应采取针对性的个体化措施防治不同特征群体的心血管疾病.