代谢综合征、吸烟对冠状动脉钙化的影响

Effect of metabolic syndrome and smoking on coronary artery calcification

目的观察代谢综合征（metabolic syndrome，MS）、吸烟对冠状动脉钙化（coronary artery calcification，CAC）的影响。方法回顾性分析2014年1月至2015年1月在广州市第一人民医院心内科住院并接受320排螺旋计算机断层扫描心脏冠状动脉成像检查的400例患者的资料，其中MS组130例，非MS组270例。比较两组MS相关指标、尿酸、D-二聚体、血肌酐的差异。以冠状动脉钙化积分（coronary artery calcium score，CACS）为应变量做Logistic回归分析，并分析CAC与Ms及吸烟状态的相关性。结果与非MS组相比，Ms组CAC、年龄、体质量指数、收缩压、舒张压、三酰甘油（triacylglycerol，TG），总胆固醇（totalcholesterol，TC），低密度脂蛋白胆固醇（low—density lipoprotein cholesterol，LDL—C），高密度脂蛋白胆固醇（high—density lipoprotcin cholesterol，HDL—C）、空腹血糖（FBG）、尿酸浓度明显升高，差异有统计学意义（P〈O．05）。经多元逐步Logistic回归分析发现，MS、男性、吸烟、年龄、TC、LDL—C、体质量是CAC的危险因素（P〈0．05），而HDL—C、舒张压则是CAC的保护因素（P〈O．05）。吸烟合并MS患者发生CAC的风险性更加显著（OR：2．372，95％CI：1．125～5．003，P〈0．05）。结论MS和吸烟是CAC的显著危险因素，MS合并吸烟会使发生CAC的危险性进一步增加。

Objectives To investigate the effect of metabolic syndrome （MS） and smoking on coronary artery calcification （CAC）. Methods Clinical date of four hundred patients who received 320-detector row spiral computed tomography scanning examinations from January 2014 to January 2015 in Guangzhou No.1 People＇s Hospital were analyzed retrospectively. The patients were divided into two groups： MS group （n=130） and non-MS group （n=270）. Biochemical indicators of MS, uric acid （UA）, D-dimer and creatinine of the two groups were compared. Logistic analysis was used to study the correlation between CAC, MS and smoking regarding the coronary artery calcium score （CACS） as the dependent variable. Results Compared with non-MS group, CAC, age, body mass index （BMI）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, concentration of triaeylglyeerol （TG）, total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, high-density lipoprotein cholesterol （HDL-C）, fasting blood glucose （FBG） and UA in MS group significantly increased （P〈0.05）. Multivariate stepwise Logistic regression analysis found that MS, male, smoking, age, TC, LDL-C and body weight were risk factors of CAC （P〈0.05）; HDL-C and DBP were protective factors of CAC （P〈0.05）. Smoking combined with MS was significantly associated with CAC （OR： 2.372, 95%CI： 1.125-5.003,P〈0.05）. Conclusions MS and smoking are significant risk factors of CAC. A combination of MS and smoking is associated with a greater risk of CAC.