The relationship between arterial stiffness and complex profiles of blood lipid in hypertensions
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摘要:
目的 通过引入血脂综合指标探讨高血压病患者血脂异常与大动脉僵硬度异常的相关性。 方法 本研究共纳入高血压病随诊或疑诊动脉粥样硬化相关疾病患者431例。对所有入组患者依据有无高血压病及血脂异常病史分为无高血压病和血脂异常病史组（A组）、有血脂异常病史但无高血压病史组（B组）、有高血压病史但无血脂异常病史组（C组）、有高血压病及血脂异常病史组（D组）。依据总胆固醇（total cholesterol，TC）、甘油三酯（triglyceride，TG）、高密度脂蛋白胆固醇（high density lipoprotein-cholesterol，HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein-cholesterol，LDL-C）等血脂指标分别计算血浆致动脉粥样硬化指数（atherogenic index of plasma，AIP）、非高密度脂蛋白胆固醇（non-high density lipoprotein-cholesterol，non-HDL-C）、TC/HDL-C、动脉硬化指数（atherogenic index，AI）等血脂综合指标，比较各指标组间差异。采用多元线性偏相关分析探讨各血脂指标与肱踝动脉脉搏波传导速度（brachial-ankle pulse wave velocity，baPWV）的相关性。 结果 TC、TG、HDL-C、AIP、AI、non-HDL-C及TC/HDL-C在各组间总体比较差异均存在统计学意义（均有P < 0.05）。针对高血压病患者（C组、D组）进行多元线性偏相关分析，结果显示，TG、HDL-C、AIP、AI、TC/HDL-C与baPWV均呈正相关关系（均有P < 0.05），TC、LDL-C、non-HDL-C与baPWV均无明显相关性（均有P>0.05）。 结论 高血压患者血脂水平与大动脉僵硬度可能存在相关性，AI、AIP及TC/HDL-C等血脂综合指标可能更好反映高血压病患者血脂异常与大动脉僵硬度异常的相关趋势。 Abstract:Objective To further explore the relationship between blood lipid and arterial stiffness by complex blood lipid profiles. Methods 431 subjects with hypertensions or inpatients with suspension of atherosclerosis-related diseases were included. The subjects were grouped into Group A (no history of hypertension and dyslipidemia), Group B (with history of dyslipidemia but not hypertension), Group C (with history of hypertension but not dyslipidemia) and Group D (with history of hypertension and dyslipidemia). The profiles of atherogenic index of plasma(AIP), non-high density lipoprotein-cholesterol (non-HDL-C), TC/HDL-C and atherogenic index (AI) were calculated based on lipid indexes of total cholesterol (TG), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). Brachial-ankle pulse wave velocity (baPWV) as well as blood lipid profiles were analyzed with comparisons and correlation analyses among groups. Results Total TC, TG, HDL-C, AIP, AI, non-HDL-C and TC/HDL-C were different with statistical significance (all P < 0.05). Multivariate linear partial correlation analysis of hypertensions showed that TG, HDL-C, AIP, AI, TC/HDL-C (all P < 0.05), but not TC, LDL-C and non-HDL-C (all P>0.05) were correlated to baPWV. Conclusion The blood lipid profiles of AI, AIP and TC/HDL-C may be correlated to baPWV, which may better reflect the trend of blood lipid and arterial stiffness in hypertensions. -
Key words:
- Arterial stiffness /
- Blood lipid /
- Pulse wave velocity /
- Hypertension /
- Correlation
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表 1 不同组别患者的基线情况[M(QR)]
Table 1. Baseline of included subjects[M(QR)]
特征 A组(n=20) B组(n=55) C组(n=117) D组(n=239) 总体(n=431) Z/χ2值 P值 性别(男/女) 16/4 45/10 77/40 178/61 316/115 6.022 0.111 年龄(岁) 58.00(19.00) 54.00(18.00) 64.00(24.00) 61.00(23.00) 59.00(23.00) 2.283 0.515 BMI(kg/m2) 22.86(4.01) 24.98(3.97)a 25.39(4.30)a 26.32(5.34)abc 25.70(4.87) 19.724 < 0.001 冠心病(有/无) 9/11 16/39 56/61 93/144 174/257 24.469 0.004 糖尿病(有/无) 19/1 43/12 85/32 167/72 269/111 6.824 0.078 收缩压(mm Hg) 114.00(16.00) 117.00(19.00) 129.00(23.00)ab 131.00(24.00)ab 127.00(24.00) 54.618 < 0.001 平均动脉压(mm Hg) 79.50(16.00) 89.00(15.00) 94.00(17.00)ab 99.00(19.00)abc 95.00(19.00) 46.312 < 0.001 舒张压(mm Hg) 64.50(11.00) 69.00(11.00) 73.00(13.00) 75.00(16.00) 73.00(15.00) 23.921 < 0.001 心率(次/分) 64.50(10.00) 65.00(13.00) 67.00(13.00) 65.00(12.00) 66.00(12.00) 5.116 0.164 肌酐(μmol/L) 66.50(14.00) 76.00(15.00)a 70.00(22.00)b 75.00(25.00)c 73.00(23.00) 8.769 0.033 尿酸(μmol/L) 295.50(93.00) 342.00(116.00)a 343.00(109.00)a 364.00(123.00)ac 350.00(114.00) 13.024 0.005 空腹血(mmol/L) 5.07(1.20) 5.10(1.00) 5.20(1.10) 5.30(1.30) 5.20(1.20) 6.684 0.083 尿素(μmol/L) 4.20(2.66) 4.73(2.19) 4.91(2.10) 5.03(2.19) 4.98(2.09) 5.031 0.170 注：a与A组比较P < 0.05；b与B组比较P < 0.05；c与C组比较P < 0.05。 
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表 2 各组患者血脂指标和baPWV值的比较[M(QR)]
Table 2. Comparisons of blood lipid profiles and baPWV among groups[M(QR)]
指标 A组(n=20) B组(n=55) C组(n=117) D组(n=239) 总体(n=431) t/Z值 P值 TC(mmol/L) 3.64(1.57) 4.23(1.09) 4.04(1.44) 4.30(1.71)ac 4.17(1.55) 7.964 0.047 TG(mmol/L) 1.00(0.70) 1.30(0.9)a 1.20(0.70) 1.57(1.00)c 1.30(0.90) 25.676 < 0.001 HDL-C(mmol/L) 1.19(0.34) 0.95(0.24)a 1.05(0.37) 0.99(0.35)a 1.00(0.34) 8.423 0.038 LDL-C(mmol/L) 2.26(1.06) 2.59(1.02) 2.44(1.09) 2.60(1.24) 2.50(1.16) 6.447 0.092 AIP(±s) 0.05±0.18 0.13±0.29a 0.08±0.28a 0.20±0.27ac 0.14±0.28 7.072 < 0.001 AI 2.26(0.94) 3.33(1.47)a 2.92(1.50)ab 3.40(1.73)ac 3.11(1.64) 25.965 < 0.001 TC/HDL-C 3.26(0.94) 4.33(1.47)a 3.92(1.50)ab 4.32(1.73)ac 4.11(1.64) 25.965 < 0.001 Non-HDL-C(mmol/L) 2.48(1.39) 3.08(1.19)a 3.06(1.41) 3.23(1.59)ac 3.10(1.40) 15.682 0.001 ba-PWV(cm/s) 1 361(375) 1 354(312) 1 536(386)ab 1 520(392)ab 1 504(391) 24.058 < 0.001 注：a与A组比较P < 0.05；b与B组比较P < 0.05；c与C组比较P < 0.05。
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