腹型肥胖与临床不同动脉硬化指标间的相关性研究
The Correlation Analysis of Abdominal Obesity and Different Clinical Arteriosclerosis Indexes

目的：探讨在轻中度原发性高血压患者中腹型肥胖与临床不同动脉硬化指标之间的相关性。方法：以209例轻中度原发性高血压患者为研究对象，按腹围分组，分析一般临床数据、血生化指标和各动脉硬化指标在腹围正常组与腹型肥胖组之间的差异，及腹围与各个临床动脉硬化指标之间的相关性，最后用逐步回归分析动脉硬化的独立危险因素。结果：腹型肥胖组体质指数(BMI)、甘油三酯、血清尿酸、肱踝脉搏波传导速度(baPWV)和颈动脉内膜中层厚度均显著高于腹围正常组(P < 0.05)，踝肱指数(ABI)、颈动脉斑块及其他指标在两组间均无统计学差异；同时，Pearson相关分析显示，腹围与baPWV、舒张末室间隔厚度、颈动脉内膜中层厚度之间均存在正相关，其中与baPWV之间的相关性最大，与舒张末室间隔厚度之间的相关性最小。逐步回归分析显示，腹围同时是baPWV、舒张末室间隔厚度和颈动脉内膜中层厚度的危险因素，独立于性别、BMI、血脂指标及空腹血糖等因素而存在。结论：在轻中度原发性高血压患者中，腹围作为心血管危险因素，参与高血压患者靶器官损害的每一个进程。早期积极干预患者腹围，可延缓甚至阻止患者靶器官损害。
Objective: To explore the correlation between abdominal obesity and different clinical arteriosclerosis indexes in patients with mild to moderate essential hypertension. Methods: 209 patients with mild to moderate essential hypertension were divided into different groups according to the abdominal circumference. The differences of general clinical data, blood biochemical indexes and arteriosclerosis indexes between the normal and increased abdominal circumference groups were analyzed, and the correlation between abdominal circumference and each clinical arteriosclerosis index was analyzed. Finally, the independent risk factors of arteriosclerosis were analyzed by stepwise regression. Result: The body mass index (BMI), triglyceride, serum uric acid, brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness in the abdominal obesity group were significantly higher than those in the group with normal abdominal circumference (P < 0.05). Ankle brachial index (ABI), carotid plaque and other indexes had no statistical difference between the two groups. At the same time, Pearson correlation analysis showed that there was a positive correlation between abdominal circumference and baPWV, end diastolic interventricular septal thickness and carotid intima-media thickness. The correlation was the highest with baPWV and the lowest with end diastolic ventricular septal thickness. Stepwise regression analysis showed that abdominal circumference was a risk factor for baPWV, end diastolic interventricular septal thickness and carotid intima-media thickness, independent of gender, BMI, blood lipid index and fasting blood glucose. Conclusion: As a cardiovascular risk factor, abdominal circumference is involved in every process of target organ damage in patients with mild to moderate essential hypertension. So early active intervention of abdominal circumference can delay or even prevent target organ damage.