中国人群血管内皮功能与心血管危险因素的相关性

杨娉婷; 袁洪; 王雅琴; 曹霞; 欧阳建辉; 陈志恒

doi:10.13201/j.issn.1001-1439.2015.04.019

中国人群血管内皮功能与心血管危险因素的相关性

- 1 中南大学湘雅三医院健康管理科 (长沙,410013);2 中南大学湘雅三医院临床药理中心
基金项目:
“十二五”国家科技支撑计划(No:2013BAI04B01)

湖南省科技计划基金(No:2014SK3062)

湖南省亚健康诊断与干预工程技术研究中心项目(No:2009TP4026)

详细信息

通讯作者: 陈志恒,E-mail:873127193@qq.com

中图分类号: R543

收稿日期: 2014-08-04

Associations between brachial endothelial function and cardiovascular risk factors in Chinese subjects

- 1 Department of Health Management;

More Information

Corresponding author: CHEN Zhiheng, E-mail: 873127193@qq.com

Received Date: 04 August 2014

摘要

摘要: 目的:探讨心血管危险因素与肱动脉血流介导的舒张功能(flow-mediated dilatation,FMD)在中国人群中的相关性。方法:选取2 511例年龄(46.86±9.52)岁的体检人群作为研究对象,采集研究对象的心血管危险因素(年龄、体质指数、腰围、血压、血脂、血肌酐、血尿酸、空腹血糖和吸烟情况)及病史(高血压、糖尿病、血脂异常和冠心病)信息。结果:多因素分析显示FMD与年龄(β=-0.29,P<0.001),性别(β=-0.12,P<0.001),体质指数(β=-0.12,P=0.001),腰围(β=-0.10,P=0.011),收缩压(β=-0.12,P<0.001),空腹血糖(β=-0.04,P=0.009),总胆固醇(β=-0.04,P=0.014),吸烟(β=-0.05,P=0.003),肱动脉基础内径(β=-0.35,P<0.001)呈负相关。FMD随年龄增长而下降,女性的FMD值大于男性,但在40岁左右迅速下降,在55岁后与男性无差异。结论:在中国人群中,心血管危险因素如年龄、性别、体质指数、腰围、收缩压、空腹血糖、总胆固醇、吸烟和肱动脉基础内径与血管内皮功能损害的发生有关。心血管危险因素对女性内皮功能的影响大于男性。
- 血管内皮功能 /
- 肱动脉血流介导的舒张功能 /
- 心血管危险因素
Abstract: Objective:To examine the relationship of several cardiovascular risk factors to brachial artery flow-mediated dilatation(FMD) in Chinese subjects.Method:This was a cross-sectional study.The 2 511 Chinese adults(age 46.86±9.52 years,1 891 men and 620 women) recruited from people who underwent health screening at the third Xiangya hospitals.Patients' cardiovascular risk factors(age,body mass index,waist circumference,blood pressure,cholesterol parameter creatinine,uric acid,glucose level and smoking) and prevalence of present disease(hypertension,diabetes mellitus,coronary heart disease and hyperlipidemia) were investigated.Result:Multivariate analysis revealed that FMD negatively correlated with age(β=-0.29,P<0.001),gender(β=-0.12,P<0.001),body mass index(β=-0.12,P=0.001),waist circumference(β=-0.10,P=0.011),systolic blood pressure(β=-0.12,P<0.001),fasting glucose(β=-0.04,P=0.009),total cholesterol(β=-0.04,P=0.014),smoking(β=-0.05,P=0.003),and baseline brachial artery diameter(β=-0.35,P<0.001).FMD decreased with increasing age in both genders.In women,FMD was higher than men and age-related decline in FMD was steepest after age 40;FMD was similar with men above 55 years old.Conclusion:In Chinese subjects,FMD may be a usefully marker of cardiovascular risk factors.Age,gender,body mass index,waist circumference,systolic blood pressure,fasting glucose,total cholesterol,smoking,and baseline brachial artery diameter were risk factors related to the impairment of FMD.The influence of cardiovascular risk factors on endothelial function is more in women than men.
- endothelial function /
- brachial artery flow-mediated dilatation /
- cardiovascular risk factors

HTML全文

参考文献(27)

[1]	STONER L, ERICKSON M L, YOUNG J M, et al. There's more to flow-mediated dilation than nitric oxide[J]. J Atheroscler Thromb, 2012, 19:589-600.
[2]	RUGGIERO D, PAOLILLO S, RATTA G D, et al. Endothelial function as a marker of pre-clinical atherosclerosis:assessment techniques and clinical implications[J]. Monaldi Arch Chest Dis, 2013, 80:106-110.
[3]	XU Y, ARORA R C, HIEBERT B M, et al. Non-invasive endothelial function testing and the risk of adverse outcomes:a systematic review and meta-analysis[J]. Eur Heart J Cardiovasc Imaging, 2014, 15:736-746.
[4]	KAZMIERSKI M, MICHALEWSKA-WLUDARCZYK A, KRZYCH L J. Intima-media thickness and flow-mediated dilatation in the diagnosis of coronary artery disease in perimenopausal women[J]. Pol Arch Med Wewn, 2010, 120:181-188.
[5]	聂志华,许顶立,郑侨克,等.高血压病患者心-踝血管指数与血管内皮功能相关性研究[J].临床心血管病杂志, 2014, 30(5):399-401.
[6]	CHARAKIDA M, DE GROOT E, LOUKOGEORGAKIS S P, et al. Variability and reproducibility of flow-mediated dilatation in a multicentre clinical trial[J]. Eur Heart J, 2013, 34:3501-3507.
[7]	MIZIA-STEC K, WIECZOREK J, ORSZULAK M, et al. Flow-mediated dilatation (FMD) and prevalence of cardiovascular risk factors:the value of FMD assessment in high risk patients is limited[J]. Kardiol Pol, 2014, 72:254-261.
[8]	OIKONEN M, WENDELIN-SAARENHOVI M, LYYTIKAINEN L P, et al. Associations between serum uric acid and markers of subclinical atherosclerosis in young adults. The cardiovascular risk in Young Finns study[J]. Atherosclerosis, 2012, 223:497-503.
[9]	PHILPOTT A C, LONN E, TITLE L M, et al. Comparison of new measures of vascular function to flow mediated dilatation as a measure of cardiovascular risk factors[J]. Am J Cardiol, 2009, 103:1610-1615.
[10]	YAN R T, ANDERSON T J, CHARBONNEAU F, et al. Relationship between carotid artery intima-media thickness and brachial artery flow-mediated dilation in middle-aged healthy men[J]. J Am Coll Cardiol, 2005, 45:1980-1986.
[11]	GARDIN J M, ALLEBBAN Z, WONG N D, et al. Endothelial function and urine albumin levels among asymptomatic Mexican-Americans and non-Hispanic whites[J]. Cardiovasc Ultrasound, 2008, 6:43-46.
[12]	CORRETTI M C, ANDERSON T J, BENJAMIN E J, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery:a report of the International Brachial Artery Reactivity Task Force[J]. J Am Coll Cardiol, 2002, 39:257-265.
[13]	KAWANO N, EMOTO M, MORI K, et al. Association of endothelial and vascular smooth muscle dysfunction with cardiovascular risk factors, vascular complications, and subclinical carotid atherosclerosis in type 2 diabetic patients[J]. J Atheroscler Thromb, 2012, 19:276-284.
[14]	LERMAN A, ZEIHER A M. Endothelial function:cardiac events[J]. Circulation, 2005, 111:363-368.
[15]	WILKINSON I B, FRANKLIN S S, COCKCROFT J R. Nitric oxide and the regulation of large artery stiffness:from physiology to pharmacology[J]. Hypertension, 2004, 44:112-116.
[16]	TILLING L, HUNT J, JIANG B, et al. Endothelial function does not relate to haemoglobin or serum erythropoietin concentrations and these do not explain the gender difference in endothelial function in healthy middle-aged men and women[J]. Eur J Clin Invest, 2013, 43:225-230.
[17]	MARUHASHI T, SOGA J, FUJIMURA N, et al. Relationship between flow-mediated vasodilation and cardiovascular risk factors in a large community-based study[J]. Heart, 2013, 99:1837-1842.
[18]	MARUHASHI T, NAKASHIMA A, SOGA J, et al. Hyperuricemia is independently associated with endothelial dysfunction in postmenopausal women but not in premenopausal women[J]. BMJ Open, 2013, 3:e003659.
[19]	LUNDER M, JANIC M, KEJZAR N, et al. Associations among different functional and structural arterial wall properties and their relations to traditional cardiovascular risk factors in healthy subjects:a cross-sectional study[J]. BMC Cardiovasc Disord, 2012, 12:29-32.
[20]	TOMIYAMA H, HIGASHI Y, TAKASE B, et al. Relationships among hyperuricemia, metabolic syndrome, and endothelial function[J]. Am J Hypertens, 2011, 24:770-774.
[21]	SCHNABEL R B, SCHULZ A, WILD P S, et al. Noninvasive vascular function measurement in the community cross-sectional relations and comparison of methods[J]. Circulation-Cardiovascular Imaging, 2011, 4:371-367.
[22]	HAMBURG N M, PALMISANO J, LARSON M G, et al. Relation of brachial and digital measures of vascular function in the community:the Framingham heart study[J]. Hypertension, 2011, 57:390-396.
[23]	PATEL A R, HUI H, KUVIN J T, et al. Modestly overweight women have vascular endothelial dysfunction[J]. Clin Cardiol, 2009, 32:269-273.
[24]	YEBOAH J, BURKE G L, CROUSE J R, et al. Relationship between brachial flow-mediated dilation and carotid intima-media thickness in an elderly cohort:the Cardiovascular Health Study[J]. Atherosclerosis, 2008, 197:840-845.
[25]	TOMIYAMA H, MATSUMOTO C, YAMADA J, et al. The relationships of cardiovascular disease risk factors to flow-mediated dilatation in Japanese subjects free of cardiovascular disease[J]. Hypertens Res, 2008, 31:2019-2025.
[26]	SUZUKI T, HIRATA K, ELKIND M S, et al. Metabolic syndrome, endothelial dysfunction, and risk of cardiovascular events:the Northern Manhattan Study (NOMAS)[J]. Am Heart J, 2008, 156:405-410.
[27]	RODRIGUEZ C J, MIYAKE Y, GRAHAME-CLARKE C, et al. Relation of plasma glucose and endothelial function in a population-based multiethnic sample of subjects without diabetes mellitus[J]. Am J Cardiol, 2005, 96:1273-1277.