探讨血管僵硬度新指标在性别间的差异及其影响因素

A study on a new index of vascular stiffness:gender difference and influencing factors

目的:初步探讨血管僵硬度新指标肱动脉压力容积指数(API)在性别间的差异及影响因素。方法:随机选取2020年8月—2021年9月进行年度体检的参与者4311例,依据年龄由低至高五分位数分为≤46岁组(Q1)、47~56岁组(Q2)、57~63岁组(Q3)、64~68岁组(Q4)和≥69岁组(Q5)。获取受试者一般资料后,采用袖带振荡波获取受试者的API。以API≥31定义为高API。比较5组内男女受试者的API和高API发生率的差异。采用多因素logistic回归模型分析高API发生率的影响因素。结果:①5组收缩压、高血压患病率、Framingham风险评分、10年心血管疾病风险和API差异有统计学意义,且随年龄增加而增加(P<0.001)。②Q1组男性受试者API大于女性,而在Q5组男性受试者API小于女性(P<0.01)。Q1组的男性发生高API比率高于女性(P<0.05);Q4组和Q5组女性发生高API比率高于男性(P<0.05)。③在整体研究对象中,男性、舒张压≥90 mmHg和脉搏是高API发生率的保护因素[OR(95%CI):0.65(0.46~0.84)、0.43(0.17~0.70)、0.98(0.97~0.99),P<0.01];年龄、BMI≥24 kg/m^(2)、收缩压≥140 mmHg和空腹血糖≥6.10 mmol/L是其危险因素[OR(95%CI):1.04(1.04~1.05)、1.42(1.23~1.61)、17.01(16.77~17.25)、1.40(1.19~1.61),P<0.01]。结论:在不同年龄段,API在男女间存在差异。中青年男性的动脉僵硬度更高,而老年女性反高于男性,女性、超重、高血压和高血糖者发生高API的风险更高。

Objective: To preliminarily discuss the gender differences and influencing factors of the brachial artery pressure-volume index(API),a new index of vascular stiffness.Methods: A total of 4,311 healthy subjects were screened for this study from August 2020 to September 2021 who underwent brachial artery pressure measurements during an annual medical checkup and were divided into 5 groups according to the age from low to high quintile(Q1:≤46 years old group,Q2:47~56 years old group,Q3:57~63 years old group,Q4:64~68 years old group and Q5:≥69 years old group).After collecting the general information,the API was obtained by using the cuff oscillation wave for every subject.API≥31 was defined as high API.The differences of API and high API incidence between male and female subjects in the five groups were compared.The influencing factors of high API incidence were analyzed by multivariate logistic regression.Results:①The differences in API and systolic blood pressure(SBP),the history of hypertension,the Framingham risk score,and the 10-year cardiovascular disease risk between the 5 groups were statistically significant,and they increased with age(P<0.001).②In the Q5 groups,the API of the males was lower than that of females,while the API of male subjects was greater than that of females in the Q1 group(P<0.05).The incidence of high API was higher in males than in females(P<0.05)in the Q1 group,but the incidence of high API was higher in females than in males(P<0.05)in the Q4 andQ5 groups.③Logistic regression model indicated that male,diastolic blood pressure≥90 mmHg and pulse were the protective factors for the high incidence of API(OR(95%CI)0.65(0.46~0.84),0.43(0.17~0.70),0.98(0.97~0.99),P<0.05);Age,BMI≥24 kg/m^(2),SBP≥140 mmHg and fasting blood glucose≥6.10 mmol/L were the risk factors(OR(95%CI)1.04(1.04~1.05),1.42(1.23~1.61),17.01(16.77~17.25),1.40(1.19~1.61),P<0.01).Conclusion: In different age groups,API differed between males and females.The arterial stiffness of young and middle-aged men is higher,while that of elderly women is higher than that of men.Women,overweight,hypertension and hyperglycemia have a higher risk of high API.