中老年女性静息心率与代谢综合征及其组分间的关联性研究

Correlation of resting heart rate with the metabolic syndrome and its components in middle-aged and elderly women

目的探讨中老年女性静息心率（RHR）与代谢综合征（MetS）及其相关组分之间的关联性。方法以2010年1月至2014年6月在珠海市人民医院体检科参与体检的862例中老年女性为研究对象,测量其静息心率（RHR）、身高、体重、腰围（WC）、血压、空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL）、低密度脂蛋白胆固醇（LDL）,并将研究对象按照RHR四分位数法分4组：≤70次/min、71~75次/min、76~80次/min、≥81次/min。比较不同RHR组中老年女性Met S及其各组分的患病差异;以≤70次/min组作为对照,采用Logistic回归模型分析其余3组Met S的患病风险。结果 Met S患病率随着RHR的增加呈上升趋势（χ2trend=5.23,Pttrend=0.02）,≥81次/min组Met S患病率为48.5%,显著高于≤70次/min（32.4%）、71~75次/min组（37.3%）和76~80次/min组（37.9%）,差异均有统计学意义（P〈0.05）;Met S组分析结果显示：收缩压（Ftrend=12.38,Ptrend=0.002）、FPG（Ftrend=8.56,Pttrend=0.004）和TG（Ftrend=8.53,Ptrend=0.004）随RHR加快而升高,HDL随RHR加快而降低（Ftrend=18.56,Pttrend〈0.01）,差异均有统计学意义（P〈0.05）。多因素Logistic回归分析显示,≥81次/min组中老年女性患Met S的风险较≤70次/min组增加了57%（OR=1.57,95%CI=1.08~2.29）。结论 RHR与Met S及其组分间存在相关性,可作为MetS发病的一个预测指标,为诊断和防控Met S患者进展为心脑血管疾病等不良结局提供了新的靶点和研究方向。

Objective To examine the correlation of resting heart rate（RHR） with the metabolic syndrome（Met S） and its components in middle-aged and elderly women. Methods We performed a cross-sectional analysis in a large sample of 862 middle-aged and elderly women who attended a general health screening program from January2010 to June 2014 in Zhuhai People’s Hospital and agreed to participate in our study. All participants’ body height,weight, waist circumference, blood pressure, fasting plasma glucose（FPG）, triacylglycerol（TG）, total cholesterol（TC）, low density lipoprotein cholesterol（LDL）, and high density lipoprotein cholesterol（HDL） were measured. The participants were divided into four groups according to quartiles of RHR： RHR≤70 times/min group, 71~75 times/min group, 76~80 times/min group, and ≥81 times/min group. Multiple adjusted odds ratio was calculated for having the Met S in each quartile compared to the first. Results The incidence of Met S was gradually up-regulated with the increase of RHR（χ2trend=5.23, Ptrend=0.02）, and the incidence of Met S was 48.5% in the ≥81 times/min group, significantly higher than that of the ≤70 times/min group（32.4%）, 71~75 times/min group（37.3%）, and 76~80 times/min group（37.9%）. The level of major components of Met S including systolic blood pressure（Ftrend=12.38, Ptrend=0.002）, fasting plasma glucose（Ftrend=8.56, Ptrend=0.004） and triglyceride（Ftrend=8.53, Ptrend=0.004） up-regulated with the increasing of RHR, while that of the HDL down-regulated（Ftrend=18.56, Ptrend〈0.01）. The multi-adjusted odds for the presence of the Met S increased gradually from an arbitrarily defined figure of 1.0 in the ≤70 times/min group to 1.57 in the ≥81 times/min group. Conclusion Raised RHR is closely correlated with Met S and its components, and it can be used as a predictor of Met S. The strength of this association supports the potential presence of one or more shared pathophysiological mechanisms for both RHR and the Met S.