Incidence of arteriosclerosis and associated factors in non-obese population in Meishan district in Nanjing
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摘要: 目的 探讨南京市梅山地区非肥胖人群动脉硬化(arteriosclerosis，AS)的发生率及相关危险因素。方法 收集2017年8月—2021年7月南京梅山医院体检中心招募的非肥胖人群861例，年龄24~84岁，平均(51.4±9.49)岁，其中男554例，女307例；BMI(22.69±2.50) kg/m2。采用自编问卷收集人口学与临床特征资料；采用AS测定仪测量臂踝脉搏波传导速度(brachial ankle pulse wave velocity，baPWV)，以baPWV>1 400 m/s定义为AS，将患者分为AS组(382例)和非AS组(479例)；采用彩色多普勒血流探测仪测量踝肱指数。比较两组之间临床资料的差异，并采用二元多因素logistic回归分析非肥胖人群发生AS的相关因素。结果 非肥胖人群AS的发生率为44.37%(382/861)，二元多因素logistic回归分析结果显示，年龄(OR=1.11，95%CI 1.09~1.14)、收缩压(OR=1.09，95%CI 1.07~1.10)、脂肪肝(OR=1.82，95%CI 1.15~2.88)是AS的危险因素，BMI(OR=0.86，95%CI 0.80~0.92)是AS的保护因素。结论 非肥胖人群AS的发生率较高，需要重点关注高龄、高收缩压、脂肪肝和低体重人群。Abstract: Obstractive The aim of this study was to explore the incidence and related risk factors of arteriosclerosis(AS) in nonobese individuals in Meishan, Nanjing.Methods A total of 861 nonobese individuals, aged 24-84 years, with an average age of(51.4 ± 9.49) years, in the Nanjing Meishan Hospital Physical Examination Center from August 2017 to July 2021 were recruited, including 554 males and 307 females. The average BMI is(22.69 ± 2.50) kg/m2. Demography and clinical characteristics were collected by self-designed questionnaires; the brachial ankle pulse wave velocity(baPWV) was measured using an arteriosclerosis tester, the participants were divided into AS group(n=382) and non-AS group(n=479) with baPWV greater than 1400 m/s defined as AS; the ankle brachial index was measured using a color Doppler blood flow detector. Compare the differences in clinical data between two groups, and use binary multivariate logistic regression to analyze the relevant factors for the occurrence of AS in nonobese individuals.Results The incidence of AS in nonobese individuals was 44.37%(382/861). The results of binary multivariate logistic regression analysis showed that age(OR=1.11, 95%CI: 1.09-1.14), systolic blood pressure(OR=1.09, 95%CI: 1.07-1.10), fatty liver(OR=1.82, 95%CI: 1.15-2.88) were risk factors, while body mass index(OR=0.86, 95%CI: 0.80-0.92) was protective factor.Conclusion The incidence of arteriosclerosis in nonobese individuals is relatively high, and it is necessary to focus on the elderly, SBP, fatty liver, and low weight individuals.
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Key words:
- nonobese population /
- arteriosclerosis /
- arm and ankle pulse wave velocity
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表 1 两组一般资料
Table 1. General data between two groups
例(%), X±S, M(P25, P75) 项目 总体(861例) AS组(382例) 非AS组(479例) t/χ2/Z P 性别 5.39 0.022 男 554(64.2) 262(68.6) 292(61.0) 女 307(35.8) 120(31.4) 187(39.0) 年龄/岁 51.40±9.49 55.57±8.54 48.08±8.89 -2.51 ＜0.001 BMI/(kg/m2) 22.69±2.50 22.97±2.45 22.47±2.52 -2.91 ＜0.001 SBP/mmHg 119.61±14.90 127.12±14.89 113.61±11.90 -4.80 ＜0.001 DBP/mmHg 75.72±9.98 80.52±9.95 71.89±8.19 -3.96 ＜0.001 AST/(IU/L) 20.39±7.10 21.45±7.64 19.54±6.52 -3.97 ＜0.001 ALT/(IU/L) 21.58±2.02 23.22±12.52 20.27±11.44 -3.60 ＜0.001 FBG/(mmol/L) 5.42±0.77 5.59±0.96 5.29±0.54 -5.66 ＜0.001 脂肪肝 221(25.7) 127(37.1) 94(19.2) 20.67 ＜0.001 目前吸烟 183(21.3) 76(19.9) 107(22.3) 0.76 0.403 LDL-C/(mmol/L) 3.30±0.82 3.38±0.85 3.23±0.79 -2.73 0.006 血尿酸/(μmol/L) 458.88±117.96 473.70±114.43 447.06±119.52 -3.31 0.001 TG/(mmol/L) 1.10±0.84 1.23±0.84 0.99±0.82 -4.27 ＜0.001 TC/(mmol/L) 5.41±0.93 5.56±0.93 5.30±0.91 -4.13 ＜0.001 γ-GT/(IU/L) 18(14，27) 21(16，30) 17(12，23) -6.77 ＜0.001 eGFR/(mL/min/1.73m2) 70.37±11.94 67.23±10.86 72.88±12.17 7.09 ＜0.001 ABI 1.19±0.09 1.21±0.11 1.18±0.07 -3.75 ＜0.001 腰围/cm 86.99±5.50 87.12±5.45 86.86±5.52 -0.69 0.245 
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表 2 多因素logistic回归分析
Table 2. Multivariate logistic regression analysis
变量 OR 95%CI P 性别 1.17 0.74~1.86 0.492 年龄 1.11 1.09~1.14 ＜0.001 BMI 0.86 0.80~0.92 ＜0.001 SBP 1.09 1.07~1.10 ＜0.001 AST 1.01 0.99~1.03 0.486 FBG 1.08 0.83~1.41 0.580 血尿酸 1.00 0.99~1.00 0.687 LDL-C 1.04 0.84~1.29 0.710 脂肪肝 1.82 1.15~2.88 0.011 eGFR 0.99 0.97~1.00 0.110 ABI 4.58 0.68~30.66 0.117 γ-GT 1.00 0.99~1.01 0.883 TG 1.23 0.96~1.57 0.100
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[1] Murakami T. Atherosclerosis and arteriosclerosis[J]. Hypertens Res, 2023, 46(7): 1810-1811. doi: 10.1038/s41440-023-01284-0
[2] Poznyak A, Grechko AV, Poggio P, et al. The diabetes mellitus-atherosclerosis connection: the role of lipid and glucose metabolism and chronic inflammation[J]. Int J Mol Sci, 2020, 21(5): 110.
[3] 彭林玉, 陈丽丹, 廖静雯. 久坐行为模式与超重或肥胖成人动脉粥样硬化风险及心率变异性的相关性研究[C]. 第十二届全国体育科学大会, 中国山东日照, 2022.
[4] Park K, Li Q, Lynes MD, et al. Endothelial cells induced progenitors into brown fat to reduce atherosclerosis[J]. Circ Res, 2022, 131(2): 168-183. doi: 10.1161/CIRCRESAHA.121.319582
[5] Das K, Das K, Mukherjee PS, et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease[J]. Hepatology, 2010, 51(5): 1593-1602. doi: 10.1002/hep.23567
[6] Kwak MS, Kim KW, Seo H, et al. Non-obese fatty liver disease is associated with lacunar infarct[J]. Liver Int, 2018, 38(7): 1292-1299. doi: 10.1111/liv.13663
[7] Herrington W, Lacey B, Sherliker P, et al. Epidemiology of atherosclerosis and the potential to reduce the global burden of atherothrombotic disease[J]. Circ Res, 2016, 118(4): 535-546. doi: 10.1161/CIRCRESAHA.115.307611
[8] 中国营养学会肥胖防控分会. 中国居民肥胖防治专家共识[J]. 中国预防医学杂志, 2022, 23(5): 321-339. doi: 10.16506/j.1009-6639.2022.05.001
[9] 中国医疗保健国际交流促进会. 同步四肢血压和臂踝脉搏波速度测量临床应用中国专家共识[J]. 中国循环杂志, 2020, 35(6): 521-528. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXH202006001.htm
[10] Zheng M, Zhang X, Chen S, et al. Arterial stiffness preceding diabetes: a longitudinal study[J]. Circ Res, 2020, 127(12): 1491-1498. doi: 10.1161/CIRCRESAHA.120.317950
[11] 王明海, 于振海, 张曙光, 等. 踝肱指数在下肢动脉缺血性疾病中的临床应用[J]. 中国血管外科杂志(电子版), 2011, 3(1): 59-61. https://www.cnki.com.cn/Article/CJFDTOTAL-XGWK201101034.htm
[12] Moreyra E Jr, Moreyra C, Tibaldi MA, et al. Concordance and prevalence of subclinical atherosclerosis in different vascular territories[J]. Vascular, 2020, 28(3): 285-294. doi: 10.1177/1708538119894178
[13] Bergström G, Persson M, Adiels M, et al. Prevalence of subclinical coronary artery atherosclerosis in the general population[J]. Circulation, 2021, 144(12): 916-929. doi: 10.1161/CIRCULATIONAHA.121.055340
[14] Wang X, Li W, Song F, et al. Carotid atherosclerosis detected by ultrasonography: a national cross-sectional study[J]. J Am Heart Assoc, 2018, 7(8): 110.
[15] Spannella F, Di Pentima C, Giulietti F, et al. Prevalence of subclinical carotid atherosclerosis and role of cardiovascular risk factors in older adults: atherosclerosis and aging are not synonyms[J]. High Blood Press Cardiovasc Prev, 2020, 27(3): 231-238. doi: 10.1007/s40292-020-00375-0
[16] Pan Y, Jing J, Cai X, et al. Prevalence and vascular distribution of multiterritorial atherosclerosis among community-dwelling adults in southeast China[J]. JAMA Netw Open, 2022, 5(6): e2218307. doi: 10.1001/jamanetworkopen.2022.18307
[17] Aday AW, Matsushita K. Epidemiology of peripheral artery disease and polyvascular disease[J]. Circ Res, 2021, 128(12): 1818-1832. doi: 10.1161/CIRCRESAHA.121.318535
[18] Wolf D, Ley K. Immunity and inflammation in atherosclerosis[J]. Circ Res, 2019, 124(2): 315-327. doi: 10.1161/CIRCRESAHA.118.313591
[19] 孙旭, 袁洪, 黄志军, 等. 300例高血压前期者脉搏波传导速度与颈动脉硬化改变及相关性[J]. 中国动脉硬化杂志, 2009, 17(10): 823-826. https://www.cnki.com.cn/Article/CJFDTOTAL-KDYZ200910007.htm
[20] 陈贻珊, 李俊平, 孔振兴, 等. 动脉硬化对成年人心脏结构、功能及运动变化特征的影响[J]. 中国动脉硬化杂志, 2018, 26(11): 1140-1146. doi: 10.3969/j.issn.1007-3949.2018.11.012
[21] Metcalf PA, Meyer ML, Tanaka H, et al. Longitudinal associations of blood pressure with aortic stiffness and pulsatility: the Atherosclerosis Risk in Communities Study[J]. J Hypertens, 2021, 39(5): 987-993. doi: 10.1097/HJH.0000000000002731
[22] Simon TG, Roelstraete B, Hagström H, et al. Non-alcoholic fatty liver disease and incident major adverse cardiovascular events: results from a nationwide histology cohort[J]. Gut, 2022, 71(9): 1867-1875. doi: 10.1136/gutjnl-2021-325724
[23] Wu M, Zha M, Lv Q, et al. Non-alcoholic fatty liver disease and stroke: A Mendelian randomization study[J]. Eur J Neurol, 2022, 29(5): 1534-1537. doi: 10.1111/ene.15277
[24] 邓江, 韩致毅, 肖彩兰, 等. 非肥胖型脂肪肝患病率及影响因素分析[J]. 临床肝胆病杂志, 2021, 37(11): 2600-2604. https://www.cnki.com.cn/Article/CJFDTOTAL-LCGD202111027.htm
[25] Lin L, Zhang J, Jiang L, et al. Transition of metabolic phenotypes and risk of subclinical atherosclerosis according to BMI: a prospective study[J]. Diabetologia, 2020, 63(7): 1312-1323.
[26] 王耀羚, 戚本玲, 白丽娟, 等. 基于肥胖与肌量划分的人体成分类型与动脉硬化的关系研究[J]. 临床心血管病杂志, 2020, 36(10): 906-913. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2020.10.007
[27] Huang J, Chen Z, Yuan J, et al. Association Between Body Mass Index(BMI)and Brachial-Ankle Pulse Wave Velocity(baPWV)in Males with Hypertension: A Community-Based Cross-Section Study in North China[J]. Med Sci Monit, 2019, 25: 5241-5257.
[28] 章佳, 赵亚超, 王飞, 等. 超重和非超重人群颈动脉斑块特征的比较研究[J]. 临床心血管病杂志, 2022, 38(10): 828-833. https://lcxxg.whuhzzs.com/article/doi/10.13201/j.issn.1001-1439.2022.10.014
[29] Charakida M, Jones A, Falaschetti E, et al. Childhood obesity and vascular phenotypes: a population study[J]. J Am Coll Cardiol, 2012, 60(25): 2643-2650.
[30] Bravo PE, Morse S, Borne DM, et al. Leptin and hypertension in obesity[J]. Vasc Health Risk Manag, 2006, 2(2): 163-169.
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