心血管病住院患者代谢综合征与ASCVD的风险因素分析

Analysis of risk factors of metabolic syndrome and ASCVD in hospitalized patients with cardiovascular disease

目的分析心血管病住院患者代谢综合征(MS)与动脉粥样硬化性心血管疾病(ASCVD)风险预测(China-PAR)评分及与临床资料的相关性,并探究ASCVD的风险因素。方法收集2018年4月~2019年3月中南大学湘雅医院符合纳入标准的心血管病住院患者327例,进行病史采集和体格检查。应用国际糖尿病联盟诊断标准将患者分为MS组(201例)及非MS组(126例),应用China-PAR模型进行ASCVD风险评估,并根据China-PAR评分的高低将患者分成低中危组(188例)和高危组(139例)进行比较分析,采用logistic回归进行统计学分析。结果本研究患者MS发生率为61.47%(201/327)。MS组和非MS组在性别、腹围、体重指数、三酰甘油、高密度脂蛋白、空腹血糖、收缩压、糖化血红蛋白、高血压和糖尿病病史方面比较,差异均有统计学意义(均P<0.05)。China-PAR总得分为(9.97±6.00)分,低中危组和高危组在年龄、空腹血糖、糖化血红蛋白、收缩压、高血压和糖尿病病史方面比较,差异均有统计学意义(均P<0.05)。logistic回归分析显示,MS(OR=1.665,95%CI:1.001~2.770,P=0.050)、年龄≥65岁(OR=5.569,95%CI:3.324~9.330,P=0.000)及酗酒史(OR=2.348,95%CI:1.130~4.877,P=0.022)是ASCVD的风险因素。结论心血管病住院患者MS发生率明显高于普通人群,有MS、老龄及酗酒是ASCVD的主要风险因素。

Objective To analyze the correlation between the metabolic syndrome(MS)in hospitalized patients with cardiovascular disease and prediction for atherosclerotic cardiovascular disease(ASCVD)risk in China(China-PAR)score and the clinical data,and to explore the risk factors of ASCVD.Methods From April 2018 to March 2019,327 patients with cardiovascular diseases who met the inclusion criteria in Xiangya Hospital Central South University were collected for medical history collection and physical examination.Patients were divided into MS group(201 cases)and non-MS group(126 cases)using the International Diabetes Federation diagnostic criteria.ASCVD risk assessment was carried out with the China-PAR model,and the patients were divided into the low-medium-risk group(188 cases)and the high-risk group(139 cases)for comparative analysis based on the score of China-PAR.Logistic regression was used for statistical analysis.Results In this study,the MS incidence rate of the patients was 61.47%(201/327).There were statistically significant differences between the MS group and the non-MS group in gender,abdominal circumference,body mass index,triglyceride,high-density lipoprotein,fasting blood glucose,systolic pressure,glycosylated hemoglobin,hypertension and diabetes history(all P<0.05).The total score of China-PAR was(9.97±6.00)scores.There were statistically significant differences in age,fasting blood glucose,glycosylated hemoglobin,systolic pressure,hypertension and diabetes history between the low-medium-risk group and the high-risk group(all P<0.05).Logistic regression analysis showed that MS(OR=1.665,95%CI:1.001 to 2.770,P=0.050),age≥65 years(OR=5.569,95%CI:3.324 to 9.330,P=0.000)and history of alcoholism(OR=2.348,95%CI:1.130 to 4.877,P=0.022)were ASCVD risk factors.Conclusion The incidence of MS in hospitalized patients with cardiovascular disease is significantly higher than that of the general population.Inpatients with MS,old age,and alcohol abuse are risk factors of ASCVD.