Metabolic syndrome and progression of atherosclerosis among middle-aged US adults
Metabolic syndrome and progression of atherosclerosis among middle-aged US adults
复制标题
DOI：
10.5551/jat.13.46
复制
发表时间：
2006-02-01
影响因子：
4.4
通讯作者：
Fan, Amy Z.
中科院分区：
文献类型：
--
作者：
Fan, Amy Z.
代谢综合征，表现为胰岛素抵抗/高胰岛素血症、肥胖、中心性肥胖、致动脉粥样硬化性血脂异常和高血压，导致动脉粥样硬化性心血管疾病。然而，代谢综合征的指标是否与亚临床动脉粥样硬化共同或单独相关仍存在争议。在代谢综合征导致动脉粥样硬化进展的机制中是否存在性别差异也是未知的。本研究对两种模型进行了比较。模型1假设潜在因素代谢综合征本身影响亚临床动脉粥样硬化(集体效应模型)；模型2假设综合征的影响是通过其指标(个体效应模型)中介的。数据来自洛杉矶动脉粥样硬化研究。队列包括573名成年人(年龄40-60岁)，他们没有心血管疾病的症状。通过B型超声测量颈总动脉内中膜厚度(CCA-IMT)来评估亚临床动脉粥样硬化。从1995年到1999年，每隔一年半完成三次检查。采用SAS8.2和AMOS 4.0软件进行统计分析。结果表明，代谢综合征的致动脉粥样硬化作用是通过其指标介导的；代谢综合征致动脉粥样硬化的机制存在性别差异。中心性肥胖仅与男性的基线IMT显著相关，而甘油三酯仅与女性的IMT进展显著相关。无论是男性还是女性，收缩压都与基线和进展显著相关。然而，在多变量模型中，尽管空腹胰岛素与代谢综合征的其他组成部分显著相关，但并未发现空腹胰岛素与IMT的基线和进展显著相关。
Metabolic syndrome, indicated by insulin resistance/hyperinsulinemia, obesity, central obesity, atherogenic dyslipidemia, and hypertension, contributes to atherosclerotic cardiovascular disease. However, it is controversial whether the indicators of metabolic syndrome are related to subclinical atherosclerosis collectively or individually. Whether there is any gender-based difference in the mechanisms of metabolic syndrome-induced atherosclerosis progression is also unknown. Two models were compared in this study. Model 1 assumes that a latent factor, metabolic syndrome per se, impacts subclinical atherosclerosis (collective effects model); Model 2 assumes the effect of the syndrome is mediated through its indicators (individual effects model). Data were obtained from the Los Angeles Atherosclerosis Study. The cohort consists of 573 adults (age, 40-60 years) who were asymptomatic for cardiovascular disease. Subclinical atherosclerosis was assessed by measuring common carotid artery intima-media thickness (CCA-IMT) using B-mode ultrasound. Three examinations were completed at 1.5-year intervals from 1995-1999. The analyses were performed with SAS 8.2 and AMOS 4.0. The results showed that atherogenic effects of metabolic syndrome were mediated through its indicators; there were gender-based differences in the mechanisms of metabolic syndrome-induced atherosclerosis. Central obesity was significantly associated with the baseline IMT for men only, whereas triglycerides were significantly associated with the progression of IMT for women only. Systolic blood pressure was significantly associated with the baseline and progression for both men and women. However, fasting insulin was not found to be significantly associated with the baseline and progression of IMT in the multivariate model, although it was significantly associated with other components of metabolic syndrome.