中国人群血管内皮功能与心血管危险因素的相关性

Associations between brachial endothelial function and cardiovascular risk factors in Chinese subjects

目的:探讨心血管危险因素与肱动脉血流介导的舒张功能(flow-mediated dilatation,FMD)在中国人群中的相关性。方法:选取2 511例年龄(46.86±9.52)岁的体检人群作为研究对象,采集研究对象的心血管危险因素(年龄、体质指数、腰围、血压、血脂、血肌酐、血尿酸、空腹血糖和吸烟情况)及病史(高血压、糖尿病、血脂异常和冠心病)信息。结果:多因素分析显示FMD与年龄(β=-0.29,P<0.001),性别(β=-0.12,P<0.001),体质指数(β=-0.12,P=0.001),腰围(β=-0.10,P=0.011),收缩压(β=-0.12,P<0.001),空腹血糖(β=-0.04,P=0.009),总胆固醇(β=-0.04,P=0.014),吸烟(β=-0.05,P=0.003),肱动脉基础内径(β=-0.35,P<0.001)呈负相关。FMD随年龄增长而下降,女性的FMD值大于男性,但在40岁左右迅速下降,在55岁后与男性无差异。结论:在中国人群中,心血管危险因素如年龄、性别、体质指数、腰围、收缩压、空腹血糖、总胆固醇、吸烟和肱动脉基础内径与血管内皮功能损害的发生有关。心血管危险因素对女性内皮功能的影响大于男性。

Objective：To examine the relationship of several cardiovascular risk factors to brachial artery flow-mediated dilatation（FMD）in Chinese subjects.Method：This was a cross-sectional study.The 2 511 Chinese adults（age 46.86±9.52 years,1 891 men and 620 women）recruited from people who underwent health screening at the third Xiangya hospitals.Patients＇ cardiovascular risk factors（age,body mass index,waist circumference,blood pressure,cholesterol parameter creatinine,uric acid,glucose level and smoking）and prevalence of present disease（hypertension,diabetes mellitus,coronary heart disease and hyperlipidemia）were investigated.Result：Multivariate analysis revealed that FMD negatively correlated with age（β=-0.29,P〈0.001）,gender（β=-0.12,P〈0.001）,body mass index（β=-0.12,P=0.001）,waist circumference（β=-0.10,P=0.011）,systolic blood pressure（β=-0.12,P〈0.001）,fasting glucose（β=-0.04,P=0.009）,total cholesterol（β=-0.04,P=0.014）,smoking（β=-0.05,P=0.003）,and baseline brachial artery diameter（β=-0.35,P〈0.001）.FMD decreased with increasing age in both genders.In women,FMD was higher than men and age-related decline in FMD was steepest after age 40;FMD was similar with men above 55 years old.Conclusion：In Chinese subjects,FMD may be a usefully marker of cardiovascular risk factors.Age,gender,body mass index,waist circumference,systolic blood pressure,fasting glucose,total cholesterol,smoking,and baseline brachial artery diameter were risk factors related to the impairment of FMD.The influence of cardiovascular risk factors on endothelial function is more in women than men.