老年男性代谢综合征患者各代谢组分与颈动脉粥样硬化的相关性研究

Study on the relationship between metabolic syndrome and intima-media thickness

目的探讨老年男性代谢综合征（MS）患者各代谢组分与颈动脉粥样硬化的相关性。方法回顾性分析，348例老年男性MS患者为MS组，75例无MS的健康体检者为对照组，比较两组入选者的体质指数、腰臀比、三酰甘油、高密度脂蛋白胆固醇、收缩压、舒张压、空腹血糖和颈动脉内膜中层厚度（IMT）。采用Pearson相关分析和多因素Logistic回归分析对IMT的相关因素进行分析。结果MS组的颈动脉粥样硬化发生率71．6％（249例）比45．3％（34例），差异有统计学意义（x^2=19．155，P=0．000）、斑块发生率53．7％（187例）比33．3oA（25例），差异有统计学意义（x^2=10．274，P=0．001）和不稳定斑块33．0％（115例）比16．0％（12例），差异有统计学意义（x^2=8．534，P=0．003）。IMT的危险因素有收缩压、三酰甘油、空腹血糖和高密度脂蛋白胆固醇，OR值分别为1．782（95％CI：1．447～2．195）、1．815（95％CI：1．528～2．156）、1．921（95％CI：1．389～2．657）和0．624（95％CI：0．511～O．762）。结论老年男性MS患者的代谢组分可增加颈动脉粥样硬化发生风险，且与颈动脉粥样硬化程度有关。

Objective To study the relationship between metabolic syndrome （MS） and intima- media thickness （IMT）. Methods Three-hundred and forty-eight elderly male patients with MS were considered as MS group, while 75 cases without MS as a control. The metabolite components, including body mass index （BMI）, waist-to-hip ratio （WHR）, triglycerides （TG）, high-density lipoprotein cholesterol （HDL-C）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, fasting plasma glucose （FPG） and carotid intima-media thickness （IMT）, were compared between groups. The related factors of IMT were analyzed using Pearson correlation analysis and multiple factors Logistic regression. Results In MS group the incidences of carotid artery atherosclerosis [-71.6%（249/348） vs. 45.3%（34/75）, Z2=19.155, P=0.000], plaque [53. 7% （187/348） vs. 33.3%（25/75）, x^2=10.274, P=0.0011and unstable plaques [33.0%（115/348）vs. 16.0%（12/ 75）, X ^2 = 8. 534, P = 0. 003] were significantly higher than those in the control group. Furthermore, Logistic regression analysis showed that the risk factors for IMT were SBP （OR = 1. 782, 95 % CI： 1.447-2.195）, TG （OR =1.815, 95%CI： 1.528-2.156）, FPG （OR=1.921, 95MCI： 1.389- 2. 657） and HDL-C （OR=0. 624, 95%CI： 0. 511-0. 762）. Conclusions The metabolic components can increase the risk of carotid atherosclerosis in elderly male patients with MS, and the risk increases with the degree of carotid artery atherosclerosis.