冠心病与代谢综合征的相关性分析

Relationship between coronary artery disease and metabolic syndrome

目的分析冠心病和病变严重程度与代谢综合征(MS)及其危险因素数量的关系。方法连续性入选2006年9月至2007年2月住院行冠状动脉(冠脉)造影的患者165例,根据冠脉造影结果分为冠心病组114例,非冠心病组51例,用冠脉病变评分和病变支数描述病变严重程度,采用ATPⅢ亚洲人群标准定义MS,分析MS和代谢异常成分及数目与冠心病及病变程度的关系。结果冠心病组男性比例和MS患病率高于非冠心病组(72.80%比50.98%,P=0.006;65.8%比39.2%,OR 2.981,95%CI 1.506～5.898,P=0.001);腰围[(92.91±9.26)cm比(89.33±9.62)cm,P=0.028]和HDL-C水平[(1.26±0.55)mmol/L比(1.78±0.95)mmol/L,P<0.001]在两组间差异也有统计学意义。Logistic回归分析显示MS(OR 3.797,95% CI 1.759～8.194,P=0.001)及低HDL-C血症(OR 2.380,95%CI 1.379～4.108,P=0.002)是冠心病相关的独立因素。MS患者比例随冠脉病变评分和受累血管支数的增多而增加,差异有统计学意义(P=0.003和0.008),MS的组成成分异常数目也随冠脉病变程度加重而增多(P=0.018和0.014)。结论 MS是冠心病的独立危险因素,随其相关危险因素异常数目的增加冠脉病变的严重程度加重。

Objective To evaluate the relationship between the severity of coronary atherosclerotic heart disease （CHD） and metabolic syndrome （MS）. Methods One hundred and sixty patients undertaken coronary angiography were consecutively enrolled. The patients were divided into CHD group （n = 114） and non-CHD group （n = 51 ） according to the results of coronary angiography. The score of coronary artery lesions and the number of vessels with lesions were used to evaluate the severity of CHD. The prevalence of MS and the number of its components were analysed in each group according to NCEP ATP m modified for Asians. Results The proportion of male patients （72.80% vs. 50. 98% ,P = 0. 006） and the prevalence of MS （65. 8% vs. 39. 2% ,OR 2. 981,95% CI 1. 506-5. 898,P =0. 001 ） were significantly higher in CHD group than in non-CHD group. Single factor analysis showed that waist circumference [ （92. 91±9.26） em vs. （89. 33 ±9. 62） era, P = 0. 028 ] and low high density lipoprotein cholesterol （HDL-C） [ （ 1.26±0. 55 ） mmol/L vs. （ 1.78 ±0. 95） mmol/L,P 〈0. 001 ] were closely related with CHD. After adjustment for gender, age, family history and life style, multivariate analysis identified MS as the strongest independent predictor of CHD （ OR 3. 797,95% CI 1. 759 - 8. 194, P=0. 001 ）, and the second was HDL-C （OR 2. 380,95% CI 1. 379 -4. 108,P =0. 002）. In CHD group, the prevalence of MS has positive relationship with coronary score and the number of lesion vessels （ P = 0. 003 and 0. 008）. The number of components of MS also showed increasing tendency with the severity of coronary lesion （P = 0. 018 and 0. 014）. Conclusions MS is an independent risk factor of CHD. The more components of the metabolic abnormality may be associated with the more severity of coronary lesion.