腹膜透析患者大动脉僵硬度与代谢综合征组分密切相关

Arterial Stiffness is Associated with Metabolic Syndrome Components in Continuous Ambulatory Peritoneal Dialysis Patients

目的探讨腹膜透析患者中大动脉僵硬度与代谢综合征成分之间的关系。方法纳入148例持续非卧床腹膜透析患者,根据其存在代谢综合征成分的个数分为非代谢综合征组、代谢综合征高危组和代谢综合征组;采用颈-股动脉脉搏波传导速度评估大动脉僵硬度。结果颈-股动脉脉搏波传导速度与年龄(r=0.427,P<0.01)、收缩压(r=0.444,P<0.01)、脉压(r=0.498,P<0.01)和血糖(r=0.366,P<0.01)呈正相关,与血清白蛋白(r=-0.216,P<0.05)呈负相关;多元回归分析显示年龄及代谢综合征评分是脉搏波传导速度的独立影响因素,在校正R2的模型里,相关系数为0.24。结论腹膜透析患者代谢综合征组分增加与大动脉僵硬度升高有密切关系,提示代谢综合征的诊断标准对预测腹膜透析患者心血管疾病仍然适用。

Aim Pulse wave velocity（PWV） reflects arterial stiffness and may provide an integrated index of vascular status and cardiovascular disease（CVD） risk. Individual components of the metabolic syndrome（MS） are well-established cardiovascular risk factors.Thus we conducted a cross-sectional study in continuous ambulatory peritoneal dialysis（CAPD） patients to explore the association of MS components with PWV. Methods Prevalent 148 CAPD patients,were categorized according to the number of traits of the MS into one of three groups（No MS,Risk of MS,MS）. Aortic stiffness was assessed by carotid-femoral PWV（C-F PWV）. Results C-F PWV was positively associated with age（r=0.427,P0.01）,systolic blood pressure（r=0.444,P0.01）,pulse pressure（r=0.498,P0.01）,and serum glucose（r=0.366,P0.01）.C-F PWV was negatively associated with serum albumin（r=-0.216,P0.05）.In a multivariate regression analysis,PWV was independently determined by age（P0.01） and MS score（P=0.01）. Adjusted R2 of the model was 0.24. Conclusion MS traits were closely associated with an increased C-F PWV,even after adjustment for confounders. This suggests that commonly recognized MS criteria are also useful when predicting CVD in CAPD patients.