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内脏脂肪指数与冠状动脉慢血流相关性分析

Correlation analysis between coronary slow flow and visceral adiposity index

    摘要
  • 摘要:
    目的 探讨内脏脂肪指数（visceral adiposity index，VAI）与冠状动脉慢血流现象（coronary slow flow phenomenon，CSFP）的相关性，分析CSFP的病理生理特征。
    方法 选取2021年1月至2022年12月在东营市人民医院行冠状动脉造影显示心外膜冠状动脉无明显病变的慢血流患者75例，为CSFP组；另选取同期因心脏症状行冠状动脉造影显示冠状动脉正常的患者65例，为正常组。测量两组患者身高、体质量、腰围（WC）等一般资料，并采集血液，检测总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇（HDL-C）、三酰甘油、空腹血糖等指标。
    结果 CSFP组和正常组体质量指数（27.65±2.90）kg/m2 vs (23.99±2.3) kg/m2, P＜0.001、WC（94.25±11.65）cm vs（83.20±5.7）cm, P＜0.001、高血压病（66.7% vs 41.5%, P=0.003）、吸烟（38.7% vs 12.3%，P＜0.001）、三酰甘油（2.49±1.04）mmol/L vs (1.48± 0.69) mmol/L, P＜0.001、HDL-C（1.18±0.26）mmol/L vs (1.05±0.22) mmol/L, P=0.003、脂蛋白a （498.69± 299.87）mmol/L vs (180.54±201.93) mmol/L, P＜0.001及VAI(4.09±1.74) vs (2.66±1.81)，P＜0.001差异有统计学意义。VAI与CSFP强相关，差异有统计学意义(P＜0.001)。根据VAI进行四分位分组，对不同VAI成年人CSFP发生风险进行多因素logistic回归分析，在校正了性别、WC、体质量指数、高血压、吸烟史、β2-微球蛋白、三酰甘油、HDL-C等因素后，高VAI组CSFP发生风险均高于低VAI组（P＜0.05）。分别绘制不同性别受试者VAI预测CSFP发生风险的受试者操作特征（ROC）曲线，男性VAI预测CSFP的曲线下面积（AUC）为0.848（95%CI 0.764~0.931），临界值为2.369；女性VAI预测CSFP的AUC为0.866（95%CI 0.754~0.978），临界值为2.525。
    结论 VAI与成年人CSFP发生率高度正相关，随着VAI增高，CSFP发生风险亦增高；VAI对CSFP有良好的预测价值。

     

    Abstract:
    Objective To explore the correlation between visceral adiposity index (VAI) and coronary slow flow phenomenon (CSFP), to analyze the pathophysiological characteristics of CSFP.
    Methods 75 patients who underwent coronary angiography in Dongying People's Hospital from January 2021 to December 2022 and showed slow flow of epicardial coronary artery without obvious lesions were selected as CSFP group. In addition, 65 patients with normal coronary artery were selected as the normal group. The height, weight, waist circumference (WC) and other general data of the two groups of patients were measured, and blood was collected to detect total cholesterol, low density cholesterol, high density lipoprotein cholesterol (HDL-C), triglyceride (TG), fasting blood glucose and other indicators.
    Results There were significant differences in body mass index (BMI), (27.65±2.90 kg/m2 vs 23.99±2.3 kg/m2, P < 0.001), WC (94.25±11.65 cm vs 83.20±5.7 cm, P < 0.001), hypertension (66.7% vs 41.5%, P= 0.003), smoking (38.7% vs 12.3%, P < 0.001), TG (2.49±1.04 mmol/L vs 1.48±0.69 mmol/L, P < 0.001), HDL-C (1.18± 0.26 mmol/L vs 1.05±0.22 mmol/L, P=0.003) and Lipoprotein(a) (498.69±299.87 mmol/L vs 180.54±201.93 mmol/L, P < 0.001), VAI (4.09±1.74 vs 2.66±1.81, P < 0.001) between CSFP group and normal group. VAI was strongly correlated with CSFP, with statistical significance (P < 0.001). According to the quartile grouping of VAI, the multi-factor logistic regression analysis of the risk of CSFP in adults with different VAI showed that the risk of CSFP in the high VAI group was higher than that in the low VAI group (P < 0.05) after adjusting for the proportion of men, WC, BMI, high blood pressure (HBP) positive rate, smoking history positive rate, β2-microglobulin (BMG), TG, HDL-C and other factors. Finally, the ROC curves of VAI predicting the risk of CSFP in subjects of different sexes were drawn respectively. The AUC of male VAI predicting CSFP was 0.848 (95% CI 0.764-0.931), and the cut-off value was 2.369 3. The AUC of female VAI predicting CSFP was 0.866 (95% CI 0.754-0.978), and the cut-off value was 2.525 1.
    Conclusions There is a strong positive correlation between VAI and the incidence of CSFP in adults. With the increase of VAI, the risk of CSFP also increases; VAI has good predictive value for CSFP.

     

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