Effects of Statin Therapy on Endothelial Function in Asymptomatic Metabolic Syndrome

Context: Endothelial dysfunction is an early predictor of adverse cardiovascular events. The present study evaluated asymptomatic metabolic syndrome (MS) patients with brachial artery endothelial dysfunction to determine whether a reversal of endothelial dysfunction occurs with statin treatment. Aim: To evaluate the short term effects of statins on endothelial function in asymptomatic metabolic syndrome patients. Methodology: This was a prospective, single centre, case-control study. We evaluated 50 recently diagnosed newly detected asymptomatic MS patients who underwent an assessment of endothelial function by brachial artery flow-mediated dilation (FMD) before and after treatment with 40 mg atorvastatin for one week. Results: A total of 50 MS patients, including 36 (62%) females and 14 (38%) males, were included in the study. The mean age of the patients was 49.70 ± 8.84 y. We identified a significant difference between cases and age- and sex-matched controls regarding baseline brachial artery FMD% (6.73 ± 2.55 vs. 11.03 ± 1.85, respectively;p < 0.001). Significant negative correlations were detected between FMD% and HDL-cholesterol (r = -0.34, p = 0.01), fasting blood sugar (r = -0.40, p = 0.004), and systolic blood pressure (r = -0.34, p = 0.015). Multiple linear regression analysis indicated that HDL-cholesterol was an independently associated factor for FMD. MS patients treated with 40 mg atorvastatin for one week showed a significant improvement in brachial artery FMD% (6.73 ± 2.55 before treatment vs. 10.19 ± 3.01 after treatment, p < 0.001). Conclusions: MS is associated with endothelial dysfunction and decreased brachial artery FMD compared with controls. Statin treatment for one week significantly improved brachial artery endothelial function in MS patients.

成纤维细胞因子21与腹型肥胖早期动脉粥样硬化相关性的研究

目的探讨腹型肥胖患者成纤维细胞因子21(FGF-21)与肱踝脉搏波传导速度(baPWV)、肱动脉内皮依赖性舒张功能(FMD)的关系。方法在体检人群中选择腹型肥胖(腹型肥胖组)患者80例及健康人(NGT组)80名,测定FGF-21、baPWV、肱动脉FMD及胰岛素抵抗指数(ln HOMA-IR)、HbA1C、血压及体脂含量(BFT)。结果腹型肥胖组baPWV、FGF-21、ln HOMA-IR高于NGT组(P<0.05或P<0.01),肱动脉FMD低于NGT组(P<0.05),FGF-21水平与BMI、BFT、WHR、TG、ln HOMA-IR、FIns呈正相关(r=0.456、0.355、0.231、0.257、0.218、0.220,P<0.05或P<0.01),Logistic回归分析发现,FGF-21、SBP、ln HOMA-IR是发生动脉粥样硬化(AS)的危险因素(OR=4.720、2.450、2.082,P<0.05)。结论腹型肥胖患者肱动脉FMD下降,而baPWV升高,FGF-21可能对预测其早期AS有意义。

肱动脉血流介导血管扩张与心血管疾病风险因素的关系

目的研究中国健康体检人群肱动脉血流介导扩张(FMD)与年龄、超敏C-反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)等心血管风险因素(CVRF)之间的关系。方法收集在某医院接受健康检查的961名成年人,检测CVRF[包括年龄、超敏C-反应蛋白、同型半胱氨酸、肌酐(Cr)、尿酸(UA)、收缩压(SP)、舒张压(DP)、总胆固醇(TCHO)、甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(GLU)、血小板计数(PLT)、尿素氮(Urea)和丙氨酸氨基转移酶(ALT)]。结果回归分析和相关分析表明FMD与hs-CRP(r=0.341,P<0.001)、肌酐(r=0.379,P<0.001)、总胆固醇(r=0.168,P<0.001)、低密度脂蛋白(r=0.240,P<0.001)呈正相关,结果均具有统计学意义;与年龄(β=-0.429,P<0.001)、尿酸(r=-0.101,P<0.01)、收缩压(r=-0.147,P<0.001)、舒张压(r=-0.323,P<0.001)、甘油三脂(r=-0.082,P<0.05)、高密度脂蛋白(r=-0.180,P<0.001)、空腹血糖(r=-0.338,P<0.001)、血小板计数(r=-0.089,P<0.01)、尿素氮(r=-0.078,P<0.05)和丙氨酸氨基转移酶(r=-0.131,P<0.001)呈负相关,结果均具有统计学意义。结论 FMD可以作为一个有效的心血管疾病风险指标,年龄、超敏C-反应蛋白、肌酐、尿酸、收缩压、舒张压、总胆固醇、甘油三脂、低密度脂蛋白、高密度脂蛋白、空腹血糖、血小板计数、尿素和丙氨酸氨基转移酶与血管内皮功能有关。