外周动脉僵硬度的肥胖形态学指标评估

Stiffness of the peripheral artery evaluated by obese morphological indexes

目的:动脉僵硬度增高引起血管早期病变的诊断和干预是延缓和控制心血管事件的根本性措施。因此,研究动脉僵硬度的相关和影响因素对重大疾病有一级预防意义。探讨几种评价超重、肥胖的形态指标如体质量指数、体脂率、腰臀比及腰围对动脉僵硬度改变的危险性影响,为预防提供依据。方法:①试验对象:选择2006年在南京市生活的不同社区40～70岁中老年人共907例,男423例,平均年龄(51±8)岁;女484例,平均年龄(50±7)岁。纳入标准:健康,无各种急性疾病,受试者自愿参加。②试验方法:由专业人员通过问卷收集试验对象一般情况、疾病史、吸烟状况、体育锻炼状况、营养饮食状况及其他生活方式资料,然后进行肱踝脉搏波传导速度和形态指标测试。评价标准:肱踝脉搏波传导速度≥1400cm/s为外周肱踝动脉硬化;体质量指数<18.5kg/m2为过轻,18.5～23.9kg/m2为标准,24.0～27.9kg/m2为超重,≥28.0kg/m2为肥胖。③试验评估:分析超重和肥胖对动脉僵硬度的影响及危险度。结果:纳入受试者907例,均进入结果分析。①体质量指数、体脂率、腰臀比、腰围4种指标评价的肥胖者,肱踝脉搏波传导速度和外周动脉硬化发生率较正常者差异均有显著性(P<0.05,P<0.01)。②年龄、腰臀比、腰围、性别、体质量指数和体脂率在外周动脉硬化组与非动脉硬化组之间差异具有显著性(P<0.05,P<0.01)。③体质量指数、体脂率、腰臀比、腰围4种指标评价的肥胖者外周动脉硬化优势比(OR)值分别为1.800、男1.902和女1.850、男2.014和女1.898、男1.517和女1.553。结论:①以体质量指数、体脂率、腰臀比、腰围4种指标评价的肥胖程度越高,外周动脉僵硬度越高。②高龄、男性、高体质量指数、高体脂率、高腰臀比、高腰围均是外周动脉硬化的危险因素。

AIM： The basic method to control cardiovascular disease is to prevent the aggravation of arteriosclerosis. Therefore, the studies on arteriosclerotic risk factors will be of significance. This article provides basis for preventing diseases by analyzing the correlation of some anthropometric indexes, such as body mass index, body fat rate, waist-to-hip ratio and the stiffness of peripheral artery. METHODS： （1）907 elderly subjects including 423 males, averagely （51 ±8） years, and 484 females, averagely （50±7） years, ranged from 40 to 70 years in Nanjing community were volunteers in 2006. Inclusive criteria： All subjects had no acute diseases and were healthy. （2）Firstly professional collected these subjects＇s disease history, smoking history, exercising status, nutrition status and life style, and then we measured some anthropometric indexes and the humerus-ankle pulse wave velocity. Humerus-ankle pulse wave velocity ≥ 1 400 cm/s indicated peripheral arteriosclerosis and body mass index 〈 18.5 kg/m2 thin, 18.5 kg/m2 ≤ body mass index 〈 23.9 kg/m2 normal, 24.0 kg/m2 ≤body mass index 〈 27.9 kg/m2 overweight, body mass index ≥ 28.0 kg/m2 obesity. （3）The influence and risk of overweight and obesity on peripheral arteriosclerosis were analyzed. RESULTS：907 subjects were involved in the result analysis.（1）Comparing with normal person, there were significant differences in both the changes in humerus-ankle pulse wave velocity and the incidence rate of peripheral arteriosclerosis for the obesities evaluated by body mass index, body fat rate, waist-to-hip ratio and waist circumference （P 〈 0.05 or P 〈 0.01）. （2）The peripheral arteriosclerosis group had significant differences with that in the non-peripheral arteriosclerosis group in age, waist-to-hip ratio, waist circumference, gender, body mass index and body fat rate （P 〈 0.05 or P 〈 0.01）. （3）The odds ratio values of peripheral arteriosclerosis for the obesities evaluated by body mass index, body fat rate, waist-to-hip ratio and waist circumference were 1.800, men 1.902 and women 1.850, men 2.014 and women 1.898, men 1.517 and women 1.553. CONCLUSlON：（1）The higher the four anthropometric indexes （body mass index, body fat rate, waist-to-hip ratio and waist circumference）, the higher the arterial stiffness is. （2）Senility, male, high body mass index, high body fat rate, high waist-to-hip ratio and high waist circumference are peripheral arteriosclerotic risk factors.