肥胖者内皮功能障碍与心血管危险因素及其聚集性

The Relationship of Endothelial Dysfunction to Cardiovascular Risk Factors and Their Clustering in Overweight and Obesity Subjects

目的 探讨血管内皮功能与肥胖合并心血管危险因素的关系。 方法 对 5 76例体重指数 (BMI)≥ 2 5 kg/ m2的中年肥胖人群检测 BMI、腰臀比 (WHR)、血压、血糖和胰岛素、血脂及胰岛素抵抗指数 (IRI) ,并测定血流介导的内皮依赖性舒张功能。按合并的心血管危险因素 (高血压、高血脂和高血糖 )分组后进行分析。 结果 (1)血压、血脂、血糖、IRI及 BMI、WHR在合并心血管危险因素的肥胖者较单纯肥胖者显著升高 ,并随着危险因素增多呈上升趋势。(2 )内皮依赖性舒张功能随着危险因素增加逐渐降低 ,其内皮功能异常的发生率呈明显升高趋势。 (3)男性肥胖者合并心血管危险因素较女性多见。(4 )合并不同数量心血管危险因素各组中 ,内皮功能异常者心血管危险因素水平均高于内皮功能正常者。(5 )内皮功能异常者合并高血脂、高血糖及代谢综合征的发生率显著高于内皮功能正常者。 结论 内皮功能障碍与肥胖者心血管危险因素的发生和聚集密切相关 ,可能是胰岛素抵抗 (IR)的前兆 ,与

Objective To explore the relationship of endothelial dysfunction to cardiovascular risk factors and their clustering in subjects with overweight and obesity. Methods In 576 subjects aged 35-55 years with overweight and obesity [body mass index (BMI)≥25kg/m 2], BMI, waist-hip ratio (WHR), blood pressure, fasting blood glucose and insulin, lipid profile and insulin resistance index IRI were measured, and the endothelial function was evaluated by the high-resolution ultrasound through the diameter change in brachial artery after reactive hyperemia. The results were analyzed according to groups stratified by the number of cardiovascular risk factors coexisting with obesity which included hypertension, hyperlipidemia and hyperglycemia. Results (1) BMI, WHR, blood pressure, FBG, fasting blood glucose, lipid profile, and IRI were higher in obesity with cardiovascular risk factors than that in simple obesity and showed a tendency of increase with the clustering of cardiovascular factors. (2) The endothelial function gradually decreased and the incidence of endothelial dysfunction gradually increased with increasing of cardiovascular risk factors. (3) Obesity with cardiovascular risk factors in men were more than women. (4) The levels of cardiovascular risk factors significantly increased in subjects with endothelial dysfunction compared with those with normal endothelial function in every group. (5) The incidence of hyperlipidemia, hyperglycemia and clustering of these three factors including hypertension were higher in obesity subjects with endothelial dysfunction than those with normal endothelial function. Conclusion Endothelial dysfunction was significantly correlated with the occurring and clustering of cardiovascular risk factors in obesity subjects. Endothelial dysfunction may be a prediction of insulin resistance (IR) and may participate in pathogenesis of metabolic diseases and cardiovascular diseases with IRI.