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目的探讨血管内皮功能障碍与单纯肥胖人群心血管危险因素的关系。方法2000年对筛查出的单纯肥胖者(体质指数≥25kg/m2)进行内皮依赖性血管舒张(EDD)功能以及体质指数(BMI)、腰围、腰臀比、血压、血脂、空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)等测定。7年后对上述人群进行随访,共随访到524例,其中男性356例,女性168例。结果EDD正常组基线时腰围、腰臀比、HOMA-IR高于EDD异常组(P<0.05或P<0.01),其余指标均差异无统计学意义。7年后随访,EDD正常组血压高于本组基线资料(P<0.05),其余指标差异无统计学意义。EDD异常组与本组基线时比较以及与EDD正常组随访时资料比较,腰臀比、收缩压、舒张压、胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹血糖、空腹胰岛素、HOMA-IR均显著升高(P<0.05或P<0.01),EDD显著降低(P<0.05)。多元逐步回归显示,腰臀比、收缩压、HOMA-IR与EDD关系最密切。结论本研究表明,血管内皮功能障碍是导致肥胖相关的心血管危险因素发生和聚集的重要原因,早期干预可能预防和延缓心血管疾病的发生。
Objective To investigate the relationship between vascular endothelial dysfunction and cardiovascular risk factors in obese people. Methods The endothelium-dependent vasodilation (EDD) and body mass index (BMI), waist circumference, waist-hip ratio, blood pressure, blood lipid, fasting blood glucose, fasting blood glucose, Insulin, insulin resistance index (HOMA-IR) and other measurements. Seven years later, the above groups were followed up for a total of 524 cases, including 356 males and 168 females. Results In the normal EDD group, waist circumference, waist-hip ratio, HOMA-IR were significantly higher than those in the EDD group (P <0.05 or P <0.01). There was no significant difference in other indexes between the two groups. After 7 years follow-up, the blood pressure of EDD normal group was higher than the baseline data of this group (P <0.05). There was no significant difference between the other indexes. Compared with the baseline EDD group and the normal EDD group, waist-hip ratio, systolic blood pressure, diastolic blood pressure, cholesterol, triglyceride, low density lipoprotein cholesterol, fasting blood glucose, fasting insulin, HOMA-IR (P <0.05 or P <0.01), EDD was significantly lower (P <0.05). Multiple stepwise regression showed that waist-hip ratio, systolic blood pressure, HOMA-IR and EDD were the most closely related. Conclusion This study shows that endothelial dysfunction is an important cause of cardiovascular risk factors associated with obesity. Early intervention may prevent and delay the occurrence of cardiovascular diseases.