内脏脂肪指数、脂质蓄积指数与脑卒中高危人群颈动脉粥样硬化的相关性研究
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(1.北京中医药大学东方医院脑病二科,北京市 100078;2.中国中医科学院望京医院康复科,北京市 100102;3.中国中医科学院西苑医院内分泌科,北京市 100091;4.首都医科大学附属北京中医医院中医药研究所,北京市 100010)

作者简介:

张丽,硕士,主治医师,研究方向为中西医结合治疗脑血管病,E-mail为dfyyzhangli@126.com。通信作者张允岭,博士,主任医师,教授,博士研究生导师,研究方向为中医脑病,E-mail为yunlingzhang2004@126.com。

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基金项目:

国家自然科学基金资助项目(81704051);国家医改重大专项“脑卒中高危人群筛查与干预试点项目”;国家中医药管理局中医药行业科研专项(201407001-8)


Association among visceral adipose index, lipid accumulation product and carotid atherosclerosis in the population at high risk of stroke
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1.Department of Neurology, Dongfang Hospital of Beijing University of Chinese Medicine, Beijing 100078, China;2.Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China;3.Department of Endocrinology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China;4.Institute of Traditional Chinese Medicine, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China)

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    摘要:

    目的 探讨脑卒中高危人群内脏脂肪指数(VAI)、脂质蓄积指数(LAP)与颈动脉粥样硬化(CAS)的相关性。方法 病例来源为北京市丰台区8家社区医院筛查出的脑卒中高危人群9 215例。通过面对面问卷调查方式收集完整的人口学信息及中医证候量表。检测项目包括体格检查、血液检查和颈动脉超声检查。通过公式计算得出VAI、LAP两个指标。运用统计学方法探讨各指标与颈动脉粥样硬化的相关性,并进行分层研究。结果 对9 215例受试者(平均年龄60±9岁,61.4%的女性)进行了分析。颈动脉粥样硬化的患病率为74.7%。CAS组在腰围、腰高比(WHtR)、女性VAI、女性LAP水平方面显著高于对照组(P<0.001)。女性内脏肥胖替代指标与颈动脉粥样硬化均呈显著相关性(P<0.001)。多因素Logistic回归显示年龄、性别(女性)、既往卒中史、高血压、糖尿病、吸烟、缺乏体育锻炼为脑卒中高危人群CAS的独立危险因素。结论 高高密度脂蛋白胆固醇(HDLC)水平、吃蔬菜、吃水果对于颈动脉粥样硬化形成有保护作用。脑卒中高危人群中女性内脏肥胖与颈动脉粥样硬化呈显著正相关。影响CAS形成的主要危险因素为VAI、年龄、性别(女性)、既往卒中史、高血压、糖尿病、吸烟、缺乏体育锻炼。

    Abstract:

    Aim To investigate the relationship between visceral adipose index (VAI) and lipid accumulation index(LAP) and carotid atherosclerosis (CAS) in high risk stroke patients. Methods The source of the case was 9 215 cases of high risk stroke population screened by 8 community hospitals in Fengtai District, Beijing. Collect complete demographic information and TCM syndrome scale through face-to-face questionnaire survey. Test items included physical examination, blood test and carotid ultrasound examination. The two indexes of VAI and LAP can be calculated by the formula. Statistical methods was used to explore the correlation between various indicators and carotid atherosclerosis, and stratified research was carried out. Results 9 215 subjects (mean age 60±9 years, 61.4% of women) were analyzed. The prevalence of carotid atherosclerosis was 74.7%. The levels of waist circumference, waist to height ratio (WHtR), female VAI, and female LAP was significantly higher in CAS group than those in control group (P<0.001). Female visceral obesity replacement indexes were significantly correlated with carotid atherosclerosis (P<0.001). Multivariate Logistic regression showed that age, gender (female), previous stroke history, hypertension, diabetes, smoking, and lack of physical exercise were independent risk factors for CAS in high risk stroke populations. Conclusion High high density lipoprotein cholesterol (HDLC) levels, eating vegetables, and fruits have a protective effect on carotid atherosclerosis. Female visceral obesity is significantly positively correlated with carotid atherosclerosis in stroke populations. The main risk factors affecting the formation of CAS are VAI, age, gender (female), history of previous stroke, hypertension, diabetes, smoking, lack of physical exercise.

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张丽,赵珈艺,范乐,解欣然,陈宝鑫,张綦慧,张允岭.内脏脂肪指数、脂质蓄积指数与脑卒中高危人群颈动脉粥样硬化的相关性研究[J].中国动脉硬化杂志,2021,29(3):240~246.

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  • 收稿日期:2020-04-01
  • 最后修改日期:2020-05-11
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  • 在线发布日期: 2021-03-02