代谢综合征青少年代谢组分与心血管疾病间的相关性

Relationship between abnormal metabolic indices and cardiac vascular disease in adolescents with metabolic syndrome

摘要:

目的 分析代谢综合征（MS）青少年代谢组分与心血管疾病（CVD）间的相关性。方法 选取MS 青少年（MS 组）288 例和健康青少年（NC 组）250 例，收集两组的临床资料和生化指标，并进一步根据性别将 MS组分为男生组167例和女生组121例，观察代谢组分布情况。采用Logistic回归分析MS及其组分与CVD的关系。 结果 ① MS 组腰围（WC）、体重指数（BMI）、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、空腹胰 岛素（FIns）、三酰甘油（TG）、总胆固醇（TC）、血尿素（SUA）及胰岛素抵抗指数（HOMA-IR）均高于NC 组，高密度脂蛋白胆固醇（HDL-C）低于NC 组（P <0.05）；②在同性别人群中，MS 组各代谢指标异常的检出 率高于NC 组（P <0.05），而在不同性别人群中，各代谢指标异常检出率比较，差异无统计学意义（P >0.05）；③ 女生组WC、BMI、SBP、FPG、FIns 及HOMA-IR 均低于男生组（P <0.05）；④在校正年龄、性别、青春 发育期后，MS 青少年、MS 男生、MS 女生患CVD 的危险性分别是正常青少年的17.5 倍（95％ CI ：10.23， 49.37）、9.74 倍（95％ CI ：3.60，30.25）和9.01 倍（95％ CI ：3.08，26.40）。MS、MS 女生、MS 男生各代谢组分与 CVD 危险性最高的分别为BP ≥ 130/85 mmHg（Ol ^ R=5.18，95%CI ：3.56，7.51）、BP ≥ 130/85 mmHg（Ol ^ R= 2.35，95%CI ：1.25，4.41）及高WC（Ol ^ R=2.84，95%CI ：1.73，4.68）。结论 MS 青少年患CVD 的风险增加，血 压升高是MS 人群和MS 女生发生CVD 危险性最高的代谢指标，高WC 是MS 男生发生CVD 危险性最高的代谢 指标。

Abstract:

Objective To analyze the relationship between abnormal metabolic indices and cardiac vascular disease (CVD) in adolescents with metabolic syndrome (MS). Methods Totally 288 adolescents with MS (MS group) and 250 healthy adolescents (NC group) were selected and the clinical data and biochemical indices were collected and compared between the two groups. Then MS group were further divided into Male group (n = 167) and Female group (n = 121) to observe metabolic components distribution. Correlation between abnormal metabolic indices and CVD were analyzed by Logistic regression analysis. Results WC, BMI, SBP, DBP, FPG, FINS, TG, TC, SUA and HOMA-IR were higher while LDL-C were lower in MS group than those in NC group, respectively (P < 0.05); the positive rates of abnormal metabolic indices were higher in MS group than thosein NC group in the same sex crowd (P < 0.05), while there were no statistically significant differencesin positive rate of abnormal metabolic indices in different gender groups (P > 0.05); WC, BMI, SBP, FPG, FIns and HOMA-IR were lower in Female group than those in Male group (P < 0.05); After factors adjustment of age, gender and puberty, onset risk of CVD in MS adolescents, male and female were 17.5 times (95% CI: 10.23, 49.37), 9.74 times (95% CI: 3.60, 30.25) and 9.01 times (95% CI: 3.08, 26.40) of those in normal adolescents respectively. The highest risk of abnormal metabolic indicesand CVD in MS adolescents, male and female were BP ≥ 130/85 mmHg (O^R = 5.18, 95%CI: 3.56, 7.51), BP ≥ 130/85 mmHg (O^R = 2.35, 95% CI: 1.25, 4.41) and high WC (O^R = 2.84, 95% CI: 1.73, 4.68). Conclusion The risk of CVD is increased in MS adolescents; the highest risk of cardiovascular event in MS adolescents and female is high BP, and the highest risk of CVD in MS mamle is high WC .