老年代谢综合征患者动脉弹性的相关研究

Study of arterial elasticity in elderly patients with metabolic syndrome

目的探讨老年代谢综合征(MS)与动脉弹性的关系。方法根据2005年国际糖尿病联盟MS诊断标准将256例受试者分为健康对照组(无任何指标异常)、非MS组(不满足MS标准但含有1个以上代谢指标异常)、MS组亚组1(腰围+其他2项指标异常)、亚组2(腰围+其他3项或以上指标异常)。应用全自动脉搏波速度测量系统测定臂—踝动脉脉搏波速度(baPWV)作为反映动脉弹性的指标,并与各临床观察指标进行多元回归分析。结果MS各亚组baPWV均显著高于健康对照组(P<0.01)及非MS组(P<0.01),非MS组与对照组间差异也有统计学意义(P<0.01)。ba PWV与年龄(r=0.543,P<0.001)、收缩压(r=0.562,P<0.001)、舒张压(r=0.387,P<0.001)、平均动脉压(r=0.468,P<0.001)、脉压(r=0.487,P<0.001)、空腹血糖(r=0.519,P<0.001)、甘油三酯(r=0.236,P<0.001)、腰围(r=0.136,P=0.029)和尿酸(r=0.162,P=0.010)呈显著正相关。多元逐步回归分析显示,年龄、收缩压和甘油三酯是影响baPWV的独立因素。结论在老年人群中MS组成成分的聚集可能促进动脉硬化的发生和发展。对老年MS患者进行代谢成分聚集的评估及进行脉搏波速度检测有助于心血管事件的一级预防。

Objective To investigate the relationship between metabolic syndrome （MS） and arterial elasticity in the aged. Methods According to the 2005 International Diabetes Federation （IDF） consensus worldwide definition of the metabolic syndrome, a total of 256 patients and healthy subjects were enrolled and divided into 4 groups, including healthy control group, non-MS group, MS subgroup 1 and MS subgroup 2. Arterial elasticity was assessed by braehialankle pulse wave velocity （baPWV） which is measured by an automatic measuring device （form PWV/AB I, Colin Co, Japan）, and multiple regression analysis was performed in baPWV and other correlative parameters. Results Compared with subjects in control group and non-MS group, subjects in MS had higher level of baPWV （P〈0.01）, and the difference of baPWV between non-MS and control group was also significant （P 〈 0.01 ）. BaPWV was significantly correlated with age （ r = 0.543, P 〈 0.001 ）, systolic blood pressure （ r = 0. 562, P 〈 0. 001 ）, diastolic blood pressure （ r = 0. 387, P 〈 0.001）, mean artery pressure （ r = 0.468, P 〈 0.001 ）, pulse pressure （ r = 0.487, P 〈 0.001 ）, fasting plasma glucose （r=0.519,P〈0.001）, triglyceride （r=0.236,P〈0.001）, waist （r=0.136,P=0.029） and uric acid （r = 0.162, P = 0.010）, and step-wise multiple regression analysis demonstrated that age, systolic blood pressure and triglyceride were positively and independently related with baPWV. Conclusion The clustering of components of MS may accelerate the occurrence and development of arterial stiffness. Evaluating the components of metabolic syndrome and measuring baPWV as early as possible is helpful to primary prevention of cardiovascular events in the elderly patients.