Ankle-brachial index and brachial-ankle pulse wave velocity are risk factors for ischemic stroke in patients with type 2 diabetes

The incidence of ischemic stroke in patients with diabetes is increasing. While brachial-ankle pulse wave velocity （BaPWV） and ankle-bra- chial index （ABI） are known to be associated with ischemic cardiovascular and cerebrovascular diseases, whether these measures predict the risk of ischemic cerebrovascular disease in diabetic patients remains unclear. 117 patients with type 2 diabetes were enrolled in this study. According to the results of head magnetic resonance imaging, the patients were divided into a diabetes-only group （n = 55） and a diabetes and ischemic stroke group （n = 62）. We then performed ABI and BaPWV examinations for all patients. Compared with the diabe- tes-only group, we found decreased ABI and increased BaPWV in the diabetes and ischemic stroke group. Multivariate logistic regression analyses revealed that BaPWV and ABI were risk factors for ischemic stroke in patients with type 2 diabetes. Our findings indicate that decreased ABI and increased BaPWV are objective indicators of increased risk of ischemic stroke in patients with type 2 diabetes.

Relationship between brachial-ankle pulse wave velocity and metabolic syndrome components in a Chinese population

The purpose of this study was to assess the relationship between arterial stiffness, as measured by brachial-ankle pulse wave velocity （baPWV）, and the presence of the metabolic syndrome （MS） in a Chinese population. A total of 4,445 subjects were enrolled. The prevalence of MS in for the general population, males and females, respectively. our study population was 21.7%, 17.2% and 25.6% With adjustments for age, gender, cigarette smoking, heart rate, total cholesterol, low-density lipoprotein （LDL） cholesterol, and the use of anti-hypertensive drug, the stepwise regression analysis showed that baPWV had a significant relationship with components of MS, including systolic blood pressure （P 〈 0.001）, diastolic blood pressure （P 〈 0.001）, glucose （P 〈 0.001）, highdensity lipoprotein （HDL） cholesterol （P = 0.04）, and triglycerides （P 〈 0.001）, but no relationship with waist circumference （P = 0.25）. With an increase in the number of the MS components, baPWV increased significantly both in women and men. This study indicated that the MS is indeed a risk factor for arterial stiffness. Monitoring of baPWV in patients with MS may help in identifying persons at high risk for cardiovascular disease.

Serum Calcium Level is Associated with Brachial-ankle Pulse Wave Velocity in Middle-aged and Elderly Chinese

Objective To study the relation between serum calcium level and elevated BaPWV in Chinese subjects. Methods The relation between serum calcium level and elevated BaPWV was studied in 9 615 subjects. The mean value of left and right BaPWV was analyzed. BaPWV was defined as high when it was31 752.5 cm/s （the upper quartile） either side. Results The BaPWV and its elevated percentage progressively increased across the quartiles of the serum calcium level （P〈0.05）. The prevalence of elevated BaPWV was significantly higher in subjects of the second, third and highest quartiles than in those of the lowest quartile （26.9%, 28.4%, and 33.2%vs 23.7%, P=0.0116, P=0.0004, and P〈0.0001）. Logistic regression analysis revealed that the risk of elevated BaPWV was 1.32- fold higher in subjects of the highest quartile than in those of the lowest quartile （OR=1.32, 95%CI：1.08-1.60）. Conclusion The elevated serum calcium level is related to an elevated BaPWV and a higher risk of arterial stiffness, independent of conventional risk factors, in middle-aged and elderly Chinese subjects.

Association of Estimated Pulse Wave Velocity and the Dynamic Changes in Estimated Pulse Wave Velocity with All-Cause Mortality among Middle-Aged and Elderly Chinese

Objective We aimed to clarify the association between estimated pulse wave velocity(ePWV)and the changes in ePWV with all-cause mortality among middle-aged and elderly Chinese.Methods Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS)from 2011-2018.The ePWV was calculated using an equation that included age and mean blood pressure(MBP).The ΔePWV was assessed as the difference in ePWV between the first two waves.Cox proportional hazard models were used to determine the association between ePWV and ΔePWV with all-cause mortality after adjustment for potential confounders.Results Of 13,116 participants during a median follow-up of 7.0 years,1,356 deaths occurred.An increased ePWV was independently associated with all-cause mortality.The hazard ratio[95% confidence interval(CI)]for participants from the 1^(st)-4^(th) quartile groups was 1.00,1.69(1.31-2.18),3.09(2.44-3.91),and 8.54(6.78-10.75),respectively.Each standard deviation(SD)increment of ePWV increased the risk of all-cause mortality by 132%.Furthermore,theΔePWV was significantly associated with a 1.28-fold(95%CI,1.18-1.38)risk of all-cause mortality per SD increment.Conclusion This cohort study provided novel evidence from a Chinese population that an increased ePWV or progression of the ePWV was independently associated with all-cause mortality,which highlighted the importance of mitigating ePWV progression in clinical practice.

Pilot study on the effect of flavonoids on arterial stiffness and oxidative stress in chronic kidney disease

BACKGROUND Flavonoids,the main class of polyphenols,exhibit antioxidant and antihypertensive properties.AIM To prospectively investigate the impact of flavonoids on arterial stiffness in patients with chronic kidney disease(CKD)stagesⅠ-Ⅳ.METHODS In this prospective,single-arm study,CKD patients with arterial hypertension and diabetes mellitus were enrolled.Baseline demographic,clinical,and laboratory variables were recorded.Patients received daily treatment with a phenol-rich dietary supplement for 3 months.Blood pressure,arterial stiffness(carotidfemoral pulse wave velocity,central pulse pressure),and oxidative stress markers(protein carbonyls,total phenolic compound,total antioxidant capacity)were measured at baseline and at study end.RESULTS Sixteen patients(mean age:62.5 years,87.5%male)completed the study.Following intervention,peripheral systolic blood pressure decreased significantly by 14 mmHg(P<0.001).Carotid-femoral pulse wave velocity decreased from 8.9 m/s(baseline)to 8.2 m/s(study end)(P<0.001),and central pulse pressure improved from 59 mmHg to 48 mmHg(P=0.003).Flavonoids also reduced oxidative stress markers including protein carbonyls(P<0.001),total phenolic compound(P=0.001),and total antioxidant capacity(P=0.013).CONCLUSION Flavonoid supplementation in CKD patients shows promise in improving blood pressure,arterial stiffness,and oxidative stress markers.

Local Pulse Wave Velocity Estimation in the Carotids Using Dynamic MR Sequences

The current study presents a new protocol for local pulse wave velocity (PWV) measurement using dynamic MR sequences, which have a high temporal resolution (TR < 6 ms). MR images were obtained at two positions along the common carotid artery, separated by a distance of 5 cm. In each phase of a MR series, carotid region was automatically extracted and then its area distension waveform could be obtained. Sixteen volunteers with no symptoms of cardiovascular diseases were studied. For local PWV estimation, three delay estimation principles were tested and produced the following values: intersecting tangents method (M1): 4.72 ± 1.40 m/s, second derivative method (M2): 4.94 ± 1.68 m/s and cross-correlation method (M3): 5.03 ± 1.17 m/s. The cross-correlation method showed a relative high reliability as its least standard deviation.

Changes in pulse pressure × heart rate, hs-CRP, and arterial stiffness progression in the Chinese general population: a cohort study involving 3978 employees of the Kailuan Company

Background Pulse wave velocity(PWV) is a marker of arterial stiffness, which represents sub-clinical atherosclerosis. Pulsatile stress and high-sensitivity C-reactive protein(hs-CRP) are associated with arteriosclerosis. However, there is no prospective data confirming whether changes in pulsatile stress and inflammatory markers affect the progression of arterial stiffness. The aim of this study was to investigate the relationships over time between the effects of changes in pulsatile stress and hs-CRP, and arterial stiffness progression during a 2-year follow-up. Methods We performed a longitudinal study involving 3978 participants. All participants underwent a physical examination in 2010–2011 and 2012–2013, during which we measured participants’ hs-CRP levels, brachial–ankle pulse wave velocity(ba PWV), and pulsatile stress. Results Baseline hs-CRP was correlated with ba PWV(r = 0.18, P = 0.000);however the correlation was weaker than that with systolic blood pressure(r = 0.65), pulsatile stress(r = 0.57), and rate-pressure product(r = 0.58). Multiple linear regression analysis demonstrated that changes in pulsatile stress, mean arterial pressure, and low-density lipoprotein-C(LDL-C) were positively correlated with changes in ba PWV, with correlation coefficients of 0.27, 0.25, and 0.07, respectively, but not with changes in hs-CRP. Moreover, each 100-a U increase in pulsatile stress, 1 mm Hg increase in mean blood pressure, and 1 mmol/L increase in LDL-C was associated with a 3 cm/s, 4.78 cm/s, and 17.37 cm/s increase in ba PWV, respectively. Conclusions Pulsatile stress increases are associated with arterial stiffness progression, but that changes in hs-CRP had no effect on arterial stiffness progression. Hs-CRP may simply be a marker of inflammation in arterial stiffness and has no association with arterial stiffness progression.

甘油三酯-葡萄糖乘积指数与动脉硬化进展的回顾性队列研究

目的:胰岛素抵抗(insulin resistance,IR)与动脉硬化和不良心血管病事件均存在密切关联。甘油三酯-葡萄糖(triglyceride-glucose,TyG)指数可作为评估IR的有效指标。本研究旨在探讨Ty G指数与动脉硬化进展风险的关系。方法:本研究为回顾性队列研究。选取2012年1月至2022年12月在中南大学湘雅三医院健康管理医学中心参加健康体检次数≥2且完成动脉硬化检测的成年人作为研究对象,收集其临床资料。TyG指数采用公式ln(甘油三酯×空腹血糖/2)计算。基线TyG指数分别以连续变量和四分位数的分类变量为自变量评价。动脉硬化进展采用臂踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的年变化速率和新发动脉僵硬度增加为因变量评价。通过线性回归模型和Cox比例风险回归模型,探索TyG指数是否为动脉硬化进展的独立风险因素。根据年龄、性别、体重指数,以及是否合并2型糖尿病、高血压和高脂血症进行亚组分析,以确定TyG指数和动脉硬化进展之间的关联特征。结果:共纳入4971名研究对象,随访时间为(3.01±1.98)年。随访期间,baPWV的年变化速率为(24.94±81.15)cm/s,共计278例为新发动脉僵硬度增加。在全面校正混杂因素后,自变量为连续变量时,基线Ty G指数与baPWV的年变化速率(β=17.5,95%CI 9.00~25.94,P<0.001)和新发动脉僵硬度增加[风险比(hazard ratio,HR)=1.43,95%CI 1.18~1.74,P<0.001]呈独立正相关。自变量为分类变量时,与第1四分位数组相比,第2、3、4四分位数组的baPWV年变化速率依次增加,新发动脉僵硬度增加的风险也依次增高(均P<0.05)。年龄≥45岁、男性、BMI<28 kg/m2、高血压病、无高血压病、无2型糖尿病和无高脂血症亚组中,基线TyG指数(连续和分类变量)与新发动脉僵硬度增加具有明显关联(均P<0.05),各亚组均不存在显著的交互作用(均P>0.05)。结论:TyG指数与动脉硬化进展风险增加独立相关,可用作体检人群动脉硬化进展风险的评估指标。

估算的脉搏波传导速度对新发糖尿病的影响

目的:探讨估算的脉搏波传导速度(ePWV)对新发糖尿病的影响。方法:以参加2006年7月至2007年10月健康体检、既往无糖尿病病史且资料完整的82 440例开滦集团公司职工为观察队列,平均随访(13.19±3.73)年。将研究人群按ePWV四分位数分为四组:Q_1组(ePWV<12.35 m/s,n=20 610)、Q_(2)组(12.35 m/s≤ePWV<13.74 m/s,n=20 610)、Q_3组(13.74 m/s≤ePWV<15.16 m/s,n=20 611)和Q_4组(ePWV≥15.16 m/s,n=20 609),计算各组糖尿病的发病密度。采用ROC曲线分析ePWV对新发糖尿病的预测价值。在校正传统心血管危险因素(包括性别、吸烟、饮酒、体育锻炼、文化程度、心血管疾病家族史、心肌梗死史、脑卒中史、体重指数、总胆固醇、空腹血糖、血尿酸和高敏C反应蛋白)后,采用多因素Cox回归模型分析ePWV对新发糖尿病的影响。结果:ePWV预测新发糖尿病的ROC曲线的AUC为0.60,最佳截断值为12.78 m/s。随着ePWV四分位数的递增,糖尿病的发病密度呈递增趋势,分别为5.84/千人年、12.04/千人年、15.70/千人年和16.87/千人年。在校正性别、基线空腹血糖、吸烟、饮酒等传统心血管危险因素后,ePWV每增加1 m/s,糖尿病的发生风险增加9%(HR=1.09,95%CI:1.08~1.11,P<0.01)。进一步分析显示,无论有无心血管危险因素、男性还是女性、年龄<51岁还是≥51岁,ePWV均与糖尿病的发生存在显著关联,HR(95%CI)分别为1.07(1.05~1.08)和1.21(1.08~1.36),1.07(1.06~1.09)和1.17(1.15~1.20),1.22(1.19~1.24)和1.06(1.04~1.07)。结论:ePWV对新发糖尿病具有一定的预测价值,是新发糖尿病的独立危险因素。

Reference values of brachial-ankle pulse wave velocity for Northern Chinese

Background Brachial-ankle pulse wave velocity （baPWV） is a reliable method for measuring arterial elasticity, but the absence of reference value for baPWV has limited its wide use. We conducted an epidemical study in north China to investigate the reference value of baPWV for Chinese people and its influential factors. Methods A total of 974 identified healthy subjects were recruited in this study. The values of baPWV were evaluated noninvasively with an automatic device. Results For healthy population, the mean value of baPWV was higher for male （P 〈0.001）. Multiple regression analysis demonstrated that both age and systolic blood pressure were positively associated with baPWV for male and female （P 〈0.001）. BaPWV value was higher in male than in female in younger group （〈50 years） but not in older group （P〈-0.001）. The upper limits of baPWV were 1394/1264 cm/s, 1435/1361 cm/s, 1552/1433 cm/s, 1597/1609 cm/s and 1798/1915 cm/s for healthy male/female at 10 years interval （age range 20-70 years）. Conclusions Aging is the most important reason of arterial stiffness, but the effect of age on baPWV augmentation is greater for healthy female than their male counterpart. The reference values of baPWV by sex and age are very useful for clinical and preventive medicine.

Increased brachial-ankle pulse wave velocity is associated with impaired endothelial function in patients with coronary artery disease

Background Pulse wave velocity and flow-mediated vasodilation （FMD） are widely used as noninvasive modalities for evaluating atherosclerosis. However, it is not known whether pulse wave velocity is related to FMD in patients with coronary artery disease （CAD）. Therefore, the present study was designed to investigate the alteration in brachial-ankle pulse wave velocity （baPWV） and endothelial function in CAD patients. Methods Thirty-three patients with CAD and thirty control subjects were recruited for this study, baPWV was measured non-invasively using a VP 1000 automated PWV/ABI analyzer （PWV/ABI, Colin Co. Ltd., Komaki, Japan）. Endothelial function as reflected by FMD in the brachial artery was assessed with a high-resolution ultrasound device. Results baPWV was increased in CAD patients compared with control subjects [（1756.1±253.1） cm/s vs （1495.3±202.3） cm/s, P〈0.01]. FMD was significantly reduced in CAD patients compared with control subjects [（5.2±2.1） % vs （11.1±4.4） %, P〈0.01]. baPWV correlated with FMD （r =-0.68, P〈0.001）. The endothelium-independent vasodilation induced by sublingual nitroglycerin in the brachial artery was similar in the CAD group compared with the control group.Conclusions CAD is associated with increased baPWV and endothelial dysfunction. Increased baPWV parallels diminished endothelial function. Our data therefore suggest that baPWV can be used as a noninvasive surrogate index in clinical evaluation of endothelial function.

Can we early diagnose metabolic syndrome using brachial-ankle pulse wave velocity in community population？

Background The prevalence of metabolic syndrome （MetS） increased recently and there was still not a screening index to predict MetS.The aim of this study was to estimate whether brachial-ankle pulse wave velocity （baPVVV）,a novel marker for systemic arterial stiffness,could predict MetS in Chinese community population.Methods A total of 2 191 participants were recruited and underwent medical examination including 1 455 men and 756 women from June 2011 to January 2012.MetS was diagnosed according to the criteria of the International Diabetes Federation （IDF）.Multiple Logistic regressions were conducted to explore the risk factors of MetS.Receiver operating characteristic （ROC） curve was performed to estimate the ideal diagnostic cutoff point of baPWV to predict MetS.Results The mean age was （45.35±8.27） years old.In multiple Logistic regression analysis,the gender,baPWV and smoking status were risk factors to MetS after adjusting age,gender,baPWV,walk time and sleeping time.The prevalence of MetS was 17.48% in 30-year age population in Shanghai.There were significant differences （Х^2=96.46,P 〈0.05） between male and female participants on MetS prevalence.According to the ROC analyses,the ideal cutoff point of baPWV was 1 358.50 cm/s （AUC=60.20%） to predict MetS among male group and 1 350.00 cm/s （AUC=70.90%） among female group.Conclusion BaPWV may be considered as a screening marker to predict MetS in community Chinese population and the diagnostic value of 1 350.00 cm/s was more significant for the female group.

绝经女性OSTA指数对baPWV的影响及对外周动脉硬化的预测价值

目的探究绝经女性亚洲骨质疏松自我评估工具(OSTA)指数对其臂-踝脉搏波传导速度(baPWV)和外周动脉硬化的影响及预测价值。方法纳入正常体检的1138例绝经女性并收集其一般临床资料,计算OSTA指数,测量baPWV,根据baPWV数值将其分为对照组(baPWV<1400 cm/s,539例)和外周动脉硬化组(baPWV≥1400 cm/s,599例)。采用线性回归、Logistic回归分析绝经女性OSTA指数对baPWV及外周动脉硬化的影响;受试者工作特征(ROC)曲线评价其对外周动脉硬化的预测价值。结果外周动脉硬化组OSTA指数低于对照组[-0.40(-2.20,1.00)vs.0.40(-0.60,1.40),P<0.05];单因素线性回归分析显示OSTA指数为baPWV的影响因素,经校正危险因素后,多因素线性回归分析提示OSTA指数仍影响baPWV数值(P<0.05),线性回归方程为baPWV=-27.911-39.752×OSTA+6.444×收缩压+7.008×舒张压+11.506×同型半胱氨酸+27.942×超敏C反应蛋白。Logistic回归分析提示OSTA指数增高为外周动脉硬化的保护因素(OR=0.664,95%CI:0.535~0.823,P<0.001)。ROC曲线分析提示OSTA指数以-1.25为最佳截断点,预测外周动脉硬化的曲线下面积为0.619,敏感度为36.2%,特异度为86.3%。结论在绝经女性中,OSTA指数为baPWV的影响因素,可通过OSTA指数预测baPWV数值,OSTA指数增高是外周动脉硬化的保护因素。

各年龄段人群血清神经元特异性烯醇化酶与外周动脉硬化的相关性分析

目的:研究各年龄段人群血清神经元特异性烯醇化酶(NSE)与外周动脉硬化的相关性。方法:以体检人群为研究对象,收集一般临床资料,采用免疫化学发光法测定血清NSE浓度,通过肱-踝脉搏波传导速度(baPWV)评估外周动脉硬化;根据年龄将研究人群分为3组:青年组(≤44岁)、中年组(45~59岁)和老年组(≥60岁),评估不同年龄组血清NSE水平与baPWV及外周动脉硬化的相关性。结果:共纳入7338名研究对象,青年组2847例,中年组3614例,老年组877例;各年龄组中,血清NSE浓度、收缩压、超敏C反应蛋白均为baPWV的独立影响因素(P<0.05),年龄越大,血清NSE浓度与baPWV相关性越高;各年龄组中,血清NSE浓度、心率、吸烟史、高血压、糖尿病、空腹血糖、收缩压、舒张压、甘油三酯、肌酐、白细胞均为外周动脉硬化(baPWV≥1400 cm/s)的危险因素(P<0.05);青年组及中年组中,高密度脂蛋白是外周动脉硬化的保护因素(P<0.05)。按NSE浓度四分位数进一步将各组研究人群分为4组,校正分析影响外周动脉硬化的因素。结果提示,与Q1组相比,除青年组外,中年组及老年组发生外周动脉硬化的OR值均随NSE浓度梯度递增而逐步递增(P<0.05)。结论:各年龄组人群中,baPWV数值随血清NSE浓度增加而增加,NSE是外周动脉硬化的独立危险因素,随着NSE浓度梯度递增,中年及老年人群发生外周动脉硬化的风险也逐步递增。

臂踝动脉脉搏波传导速度与发生恶性肿瘤的关系

目的探讨臂踝动脉脉搏波传导速度(baPWV)与发生恶性肿瘤的关系。方法采用横断面研究方法,研究对象为参加2010至2017年健康体检且同时参加baPWV检测的开滦集团职工(41404例)。按照baPWV水平将观察对象分为3组,分别为baPWV<1400 cm/s、1400 cm/s≤baPWV<1800 cm/s和baPWV≥1800 cm/s。采用多因素Logistic回归模型分析不同baPWV分组与恶性肿瘤的关系。结果观察对象年龄(48.1±12.1)岁,男性占71.9%。baPWV<1400 cm/s、1400 cm/s≤baPWV<1800 cm/s、baPWV≥1800 cm/s组发生恶性肿瘤比例分别为0.58%、0.77%、0.92%。多因素Logistic回归模型分析显示,校正混杂因素:年龄、性别、吸烟、饮酒、体育锻炼、空腹血糖、平均动脉压、腰围、体重指数、总胆固醇和C-反应蛋白,与baPWV<1400 cm/s组比较,1400≤baPWV<1800 cm/s和baPWV≥1800 cm/s组观察对象发生恶性肿瘤的OR(95%CI)值分别为1.17(1.06~1.30)、1.47(1.28~1.70)(P<0.01)。结论动脉硬化与发生恶性肿瘤有关联。

肥胖儿童臂-踝脉搏波传导速度影响因素分析

目的:探索肥胖儿童臂-踝脉搏波传导速度(baPWV)的改变,并分析其影响因素。方法:选择2021年6月至2022年10月于苏州大学附属儿童医院内分泌遗传代谢科及儿童保健科就诊的94例肥胖儿童和57例体检健康儿童。比较两组BMI、性别、年龄、血尿酸、血脂、空腹血糖和胰岛素、颈动脉内膜中层厚度(cIMT)、baPWV、BMI的Z分数(Z-BMI)、收缩压(SBP)、舒张压(DBP)、稳态模型胰岛素抵抗指数(HOMA-IR)等的差异。比较肥胖儿童中高血压组和正常血压组、青春期组和青春期前组baPWV的差异。采用多重线性回归分析baPWV的影响因素。结果:肥胖儿童的baPWV慢于健康儿童(P=0.036)。肥胖儿童中,高血压组的baPWV快于正常血压组,青春期组快于青春期前组(P<0.05)。多重线性回归分析结果显示DBP和HOMA-IR是肥胖儿童baPWV的影响因素,B(95%CI)为10.959(4.745~17.173)和3.416(0.771~6.061)。结论:肥胖儿童baPWV与血压、HOMA-IR、青春期有关。

血清Adropin浓度与踝臂指数、肱-踝动脉脉搏波传导速度的相关性

目的研究血清Adropin浓度与踝臂指数(ankle brachial index,ABI)、肱-踝动脉脉搏波传导速度(brachial ankle pulse wave velocity,Ba-PWV)的相关性。方法纳入2022年1月至2023年6月心内科住院治疗的患者179例,酶联免疫吸附法检测血清Adropin浓度,测量肱、踝动脉收缩压及Ba-PWV,计算ABI。根据ABI分组:ABI较低组(ABI<0.9,n=71)和ABI较高组(ABI≥0.9,n=108)。根据Ba-PWV分组:Ba-PWV较高组(Ba-PWV≥1400 cm/s,n=118),Ba-PWV较低组(Ba-PWV<1400 cm/s,n=61)。结果与ABI较高组比较,ABI较低组高血压发病率高、血清Adropin浓度低(P<0.001)。Logistic回归分析显示:血清Adropin浓度与低ABI呈负相关(偏相关系数为-0.715,P=0.027,OR=0.529,95%CI:0.342~0.987)。ROC分析:血清Adropin浓度<2998 pg/mL可预测低ABI及动脉粥样硬化(P<0.001),ROC曲线下面积:0.864;95%CI:(0.804~0.925),灵敏度:89.8%,特异性:81.7%。与Ba-PWV较低组比较,Ba-PWV较高组空腹血糖水平高、高血压病发病率高、血清Adropin浓度低(P<0.05)。Logistic回归分析:血清adropin浓度与高Ba-PWV呈负相关(偏相关系数为-0.562,P=0.002,OR=0.587,95%CI:0.398~0.837)。ROC分析:血清Adropin浓度<3019 pg/mL可预测高Ba-PWV及动脉粥样硬化(P<0.001),ROC曲线下面积:0.861;95%CI:(0.792~0.929),灵敏度:86.9%,特异性:53.4%。结论血清Adropin浓度与大动脉硬化及外周动脉粥样硬化相关。

ACE、APN及baPWV预测糖尿病合并高血压发生心脑血管事件的价值

目的 探讨血管紧张素转换酶(ACE)、脂联素(APN)及肱踝脉搏波传导速度(baPWV)预测糖尿病合并高血压发生心脑血管事件的价值。方法 选取2019年1月—2022年2月在我院治疗的糖尿病合并高血压患者138例,随访患者发生心脑血管事件情况,分析比较发生和未发生心脑血管事件患者ACE、APN、baPWV等临床资料差异。结果 发生心血管事件患者BMI、收缩压、甘油三酯(TG)、糖化血红蛋白(HbA1c)、ACE和baPWV明显高于未发生心血管事件患者,而APN明显低于未发生心血管事件(均P<0.05)。Logistic回归分析显示:BMI、收缩压、ACE、APN和baPWV是患者发生心血管事件的影响因素(P<0.05)。发生冠心病、缺血性脑卒中、心源性猝死和脑出血患者性别、年龄、ACE、APN、baPWV等临床资料比较差异无统计学意义(P>0.05)。ACE、APN和baPWV预测心血管事件发生的ROC曲线下面积比较,其中baPWV预测价值明显高于ACE和APN(P<0.05)。结论 ACE、APN及baPWV预测糖尿病合并高血压发生心脑血管事件有较好的应用价值。

基于超极速脉搏波技术定量评估高血压患者颈动脉脉搏波速度指数的影响因素

目的基于超极速脉搏波(ufPWV)技术定量评估高血压患者颈动脉脉搏波速度指数(PWVI)的影响因素。方法选择2018年1月至2022年8月于江苏省中医院南京中医药大学附属医院行ufPWV检测的健康成年人121名为建模组,另招募208例高血压患者为试验组。收集所有受试者的一般资料、体格检查、实验室检查与ufPWV影像学检查结果,建模组利用多元逐步线性回归分析得出理论的弹性指标方程,然后利用该方程计算PWVI进一步分析各动脉粥样硬化危险因素对PWVI的影响。结果根据建模组得出理论的弹性方程为收缩终末脉搏波速度(PWVES)(m/s)=0.083×年龄(岁)+0.036×平均动脉压(mmHg)+0.681×性别(女=0,男=1)+0.164,据此将试验组分为弹性衰退组(n=115,PWVI≥0)及弹性正常组(n=93,PWVI﹤0),两组患者性别、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖、吸烟史比较,差异均有统计学意义(P﹤0.05),PWVI的增加与TC(r=0.251,P=0.006)、LDL(r=0.401,P﹤0.01)水平呈显著正相关,与HDL(r=-0.247,P﹤0.01)水平呈显著负相关。结论基于ufPWV技术检测动脉弹性指标PWV-ES及其计算所得的PWVI可以作为评估高血压患者动脉粥样硬化弹性衰退进展的无创且可靠的评估手段。

实时剪切波弹性成像和彩色脉搏波成像技术评估痛风性关节炎患者颈动脉硬度研究

目的:探讨实时剪切波弹性成像(SWE)和彩色脉搏波成像(UFPWV)技术评估痛风性关节炎(GA)患者颈动脉硬度的应用价值。方法:选择2022年8月至2023年7月期间宜宾市第一人民医院收治的80例GA患者纳入GA组,其中24例经影像学检查确诊合并骨质侵蚀,56例未合并骨质侵蚀;另选取同期在本院进行健康体检的40名健康者纳入健康对照组。采用SWE和UFPWV技术检测所有受检者颈总动脉血管壁杨氏模量最大(Max)、最小(Min)及平均(Mean)值,以及收缩期开始时的脉搏波速度(PWVBS)和收缩期结束时的脉搏波速度(PWVES),评估颈总动脉血管壁纵向和环向血管壁硬度。比较两组杨氏模量值、PWVBS和PWVES差异,分析GA患者合并骨质侵蚀与杨氏模量值、PWVBS和PWVES的相关性。结果:GA组杨氏模量Max值(78.80±12.38)kPa、Min值(57.83±7.42)kPa、Mean值(67.67±8.38)kPa,以及PWVBS(7.06±0.59)m/s和PWVES(9.50±0.63)m/s均显著大于健康对照组,差异有统计学意义(t=11.066、8.216、11.751、14.159、19.118,P<0.05)。合并骨质侵蚀GA患者杨氏模量Max值(82.95±6.37)kPa、Min值(59.59±5.29)kPa、Mean值(72.18±7.62)kPa,以及PWVBS(7.37±0.43)m/s和PWVES(10.43±0.47)m/s均显著大于未合并骨质侵蚀患者[(77.01±5.32)kPa、(57.08±4.73)kPa、(65.73±4.54)kPa和(6.92±0.39)m/s、(9.10±0.41)m/s,t=4.309、2.099、4.699、4.586、12.720,P<0.05]。Spearman相关性分析显示,GA患者杨氏模量Max、Min及Mean值,以及PWVBS和PWVES与合并骨质侵蚀具有显著相关性(r=0.602、0.421、0.682、0.647、0.732,P<0.05)。结论:SWE和UFPWV技术可以评价GA患者血管壁硬度,GA患者颈总动脉血管壁的纵向及环向硬度高于健康人,合并骨质侵蚀的GA患者颈总动脉血管壁的纵向及环向硬度更高。