心血管危险因素与小动脉弹性的关系

Association of cardiovascular risk factors and small arterial elasticity

目的 探讨小动脉弹性下降的主要心血管危险因素及多种危险因素并存时对小动脉弹性的影响。方法 采用CVProfilorDO 2 0 2 0动脉脉搏分析仪测量大动脉和小动脉弹性指数 (C1和C2 ) ;用稳态模式评估法 (HOMA)评价胰岛素抵抗。依据中国健康人群动脉弹性功能参考标准把受试者分为小动脉弹性 (C2 )异常组和对照组 ;根据危险因素个数多少将C2 异常组分为 4个亚组 (0～ 3亚组 )。结果 (1)C2 异常组的年龄、总胆固醇 (TC)、低密度脂蛋白胆固醇 (LDL C)、空腹血糖 (FBG)、收缩压 (SBP)和舒张压 (DBP)明显高于对照组 ,而C2 明显低于对照组 (P均 <0 0 5 ) ;单因素相关分析 ,年龄、TC、LDL C、FBG、SBP和DBP分别与C2 呈负相关。 (2 )随着危险因素聚集程度的增加 ,0到3亚组C2 呈依次下降趋势 (6 5± 2 6比 5 4± 2 3比 4 7± 2 7比 3 1± 1 6 ,P <0 0 0 1) ,多个危险因素并存亚组 (3亚组 )C2 下降最显著。 (3) 3亚组血浆胰岛素浓度和胰岛素抵抗指数显著高于其他亚组 (P <0 0 5 ,P <0 0 0 1)。结论 年龄、总TC、HDL C、FBG、SBP和DBP水平增加是小动脉弹性下降的主要心血管危险因素 ,它们对小动脉弹性的影响是连续的 ;多种危险因素并存时 ,可通过协同作用使小动脉弹性降低更显著 ;胰岛素抵抗可能是危险因?

Objective To investigate the major cardiovascular risk factors affecting small arterial elasticity and the effect of combined multiple risk factors on it. Methods Arterial elasticity indexes ( C 1-large artery and C 2-small artery ) were measured with CVProfilor DO-2020. The status of insulin resistance was evaluated with HOMA ( homeostasis model assessment ). Subjects were categorized into abnormal C 2 group and control group according to the level of C 2. The former group was further divided into four subgroups (0 to 3) based on the number of risk factors. Results (1) The levels of age, total cholesterol (TC), low density lipoprotein- cholesterol (LDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP) and diastolic blood pressure (DBP) in abnormal C 2 group were higher than those in control group, whereas C 2 itself was lower than that in control group (P all <0.05). Age, TC, LDL-C, FBG, SBP and DBP were significantly inversely correlated with C 2. (2) With the clusters of risk factors increasing, C 2 was decreasing (6.5±2.6 vs 5.4±2.3 vs 4.7±2.7 vs 3.1±1.6,P<0.001). C 2 decreased significantly in subjects with multiple risk factors (subgroup 3). (3) Fasting plasma insulin and HOMA-IR (insulin resistance index) were significantly higher in subgroup 3 than in the other subgroups (P<0.05, P<0.001 respectively). Conclusions The elevations of age, TC, LDL-C, FBG, SBP and DBP were the major cardiovascular risk factors on the reduction of C 2, and the effects on it were continuously. With their concurrent effects, multiple risk factors could decrease small arterial elasticity much more significantly. Insulin resistance seems to be closely related to the clusters of multiple risk factors.