目的：探讨代谢综合征（ MS）与臂踝脉搏波速度（ baPWV）的关系。方法选取2010年10月—2013年10月华中科技大学附属协和医院心血管研究中心住院患者692例，将超重或肥胖，腰围：男≥90 cm、女≥80 cm，糖耐量异常或糖尿病，高血压作为MS基本症候群，根据患者组分不同分为MS1组（272例，仅具有MS基本症候群）、MS2组〔270例，具有MS基本症候群伴三酰甘油（ TG）异常〕、MS3组〔150例，具有MS基本症候群伴高密度脂蛋白胆固醇（ HDL-C）异常〕。另选取同期在本院体检健康者300例作为对照组。采集受试者静脉血，检测总胆固醇（TC）、TG、低密度脂蛋白胆固醇（LDL-C）、HDL-C、空腹血糖（FPG）、餐后2 h血糖（2 hPG）和超敏C反应蛋白（ hs-CRP）。并测量受试者baPWV。结果各组年龄、体质量、体质指数（ BMI）、腰围、收缩压（ SBP）、舒张压（ DBP）、脉压（ PP）、平均动脉压（ MAP）、TC、TG、LDL-C、HDL-C、FPG、2 hPG、hs-CRP和baPWV比较，差异均有统计学意义（ P＜0.05）；其中MS1组、MS2组、MS3组年龄、体质量、BMI、腰围、SBP、DBP、PP、MAP、FPG、2 hPG、hs-CRP和baPWV均高于对照组；MS2组和MS3组体质量、BMI、腰围、SBP、DBP、PP、MAP、FPG、2 hPG和baPWV均高于MS1组；MS3组男性腰围、SBP、PP、TC、LDL-C和baPWV均高于MS2组（P＜0.05）。直线相关分析结果显示，MS患者年龄、BMI、SBP、PP、MAP、TG、FPG及2 hPG与baPWV呈正相关，DBP、HDL-C与baPWV呈负相关（ P＜0.05）。多元线性回归分析结果显示，性别、年龄、BMI、SBP、DBP、2 hPG、TG是MS患者baPWV的因素（P＜0.05）。结论 MS患者异常组分越多，引起动脉硬化程度越严重，性别、年龄、BMI、血压、2 hPG、TG是MS患者baPWV增加的危险因素，对MS患者进行baPWV检测有利于其心血管事件发生的预测评估。%Objective To investigate the relationship between metabolic syndrome( MS) and brachial-ankle pulse wave velocity( baPWV). Methods A total of 692 patients who were admitted into the Cardiovascular Research Center of Union Hospital of Huazhong University of Science and Technology from October 2010 to October 2013 were enrolled. We determined a series of basic MS syndromes,including overweight or obesity,excessive waistline( male≥90 cm;female≥80 cm),abnormal glucose tolerance or diabetes mellitus,hypertension. According to different components,272 subjects with only basic MS syndromes were assigned into the MS1 group,270 subjects with both basic MS syndromes and abnormal TG were assigned into the MS2 group,and 150 subjects with both basic MS syndromes and abnormal HDL-C were assigned into MS3 group. Another 300 health subjects were enrolled as the control group. The venous blood of the subjects was sampled,and then tests were conducted on TC,TG,LDL-C,HDL-C,FPG,2 hPG and hs-CRP. The baPWV of the subjects was also measured. Results The four groups were significantly different(P<0. 05)in age,body weight,BMI,waistline,SBP,DBP,PP,MAP,TC,TG, LDL-C,HDL-C,FPG,2 hPG, hs-CRP and baPWV;MS1 group, MS2 group, MS3 group were higher ( P <0. 05 ) than the control group in age,body weight,BMI,waistline,SBP,DBP,PP,MAP,FPG,2 hPG,hs-CRP and baPWV;MS2 group and MS3 group were higher(P<0. 05)than MS1 group in body weight,BMI,waistline,SBP,DBP,PP,MAP, FPG,2 hPG and baPWV;MS3 group was higher ( P <0. 05 ) than MS2 group in the waistline of males, SBP, PP, TC, LDL-C and baPWV. The rectilinear correlation analyses showed that age,BMI,SBP,PP,MAP,TG,FPG,2 hPG were positively correlated with baPWV,and DBP and HDL-C were negatively correlated(P<0. 05)with baPWV. The multivariate linear regression correlation analyses showed gender,age,BMI,SBP,DBP,2 hPG and TG were influencing factors for baPWV of MS patients( P<0. 05 ). Conclusion More abnormal MS components are associated with severer arteriosclerosis. Gender,age,BMI,blood pressure,2 hPG,TG are influencing factors for the increase in baPWV of MS patients. The monitoring on baPWV of MS patients is helpful for the forecast evaluation of cardiovascular events.
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