缺血性胸痛患者高三酰甘油血症-腰围表型与心血管疾病危险因素聚集的关系

Relationship between hypertriglyceridemic-waist phenotype and clustering of cardiovascular risk factors in chest pain patients

目的研究缺血性胸痛患者高三酰甘油血症-腰围表型(HTWP)与心血管疾病危险因素聚集的关系。方法选择2014年4月至2015年12月在秦皇岛市第一医院就诊的胸痛患者309例,根据三酰甘油(TG)和腰围将其分为TG和腰围正常组(A组,38例)、单纯腹型肥胖组(B组,122例)、单纯高TG组(C组,18例)和HTWP组(D组,131例)。分析各组患者心血管疾病危险因素聚集检出率及HTWP与心血管疾病危险因素聚集的关系。结果 309例患者HTWP检出率为42.4%(131/309),其中男性患者HTWP检出率为37.6%(73/194),女性患者HTWP检出率为50.4%(58/115),男、女性患者HTWP检出率比较差异有统计学意义(P<0.05)。D组患者腰围、体质量指数(BMI)、TG、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和空腹血糖(FPG)均高于A组(P<0.05),高密度脂蛋白胆固醇(HDL-C)低于A组(P<0.05),TG、TC和LDL-C高于B组(P<0.05),腰围和BMI高于C组(P<0.05)。D组患者心血管疾病危险因素聚集检出率为88.5%(116/131),高于A组的36.8%(14/38)、B组的70.5%(86/122)和C组的66.7%(12/18)(P<0.05)。单因素logistic回归分析发现,腹型肥胖、高TG血症和HTWP均与心血管疾病危险因素聚集有关(P<0.05)。多因素logistic回归发现,在校正年龄、性别和BMI后,仅高TG和HTWP与心血管疾病危险因素聚集有关(P<0.05),且HTWP对心血管疾病危险因素聚集的影响最大。结论 HTWP是心血管疾病危险病因素聚集的独立预测因素。

Objective To study the relationship between hypertriglyceridemic-waist phenotype（ HTWP） and clustering of cardiovascular risk factors in chest pain patients. Methods Three hundred and nine patients with chest pain admitted to the First Hospital of Qinhuangdao from April 2014 to December 2015 were selected. They were divided into triglyceride（ TG） and waist circumference normal group（ group A,n = 38）,pure high waist circumference group（ group B,n = 122）,pure high TG group（ group C,n = 18）,and HTWP group（ group D,n = 131） according to the waist circumference and serum TG. The detection rate of clustering of cardiovascular risk factors among the four groups was analyzed; and the relationship between HTWP and clustering of cardiovascular risk factors was analyzed. Results The prevalence of HTWP in all patients was 42. 4%（ 131 /309）. The prevalence of HTWP in male patients was lower than that in female patients（ 37. 6% vs 50. 4%,P〈0. 05）.The waist circumference,body mass index（ BMI）,TG,total cholesterol（ TC）,low density lipoprotein cholesterol（ LDL-C）,and fasting plasma glucose（ FPG） of patients in group D were significantly higher than those in group A（ P〈0. 05）; but the high density lipoprotein cholesterol（ HDL-C） of patients was significantly lower than that in group A（ P〈0. 05）; the TG,TC,and LDL-C levels of patients in group D were significantly higher than those in group B（ P〈0. 05）,and waist circumference and BMI were significantly higher than those in group C（ P〈0. 05）. The prevalence of cardiovascular risk factors in group D was 88. 5%,which was significantly higher than that in group A（ 36. 8%）,B（ 70. 5%）,and C（ 66. 7%）（ P〈0. 05）. Univariate factor logistic regression analysis showed that high waist circumference,hypertriglyceridemic and HTWP were correlated with clustering of cardiovascular risk factors in chest pain patients（ P〈0. 05）. Multivariate logistic regression analysis showed that pure hypertriglyceridemic and HTWP were correlated with clustering of cardiovascular risk factors after age,sex and BMI were adjusted（ P〈0. 05）; and the HTWP had the most effect on clustering of cardiovascular risk factors. Conclusion HTWP is an independent risk factor of clustering for cardiovascular risk factors.