Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
권호 표지

The Changes of Central Aortic Pulse Wave Analysis in Metabolic Syndrome

대사증후군에서 중심대동맥압의 변화

Lee, Jee-In;Sohn, Tae-Seo;Kwon, Hyuk-Sang;Lee, Jung-Min;Chang, Sang-Ah;Cha, Bong-Yun;Son, Hyun-Shik
이지인;손태서;권혁상;이정민;장상아;차봉연;손현식

  • Published : 2008.12.01
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Abstract

The metabolic syndrome (MS) has been characterized as a cluster of risk factors that includes dyslipidemia, hypertension, glucose intolerance and central obesity. This syndrome increases the risk of cardiovascular disease. Augmentation index (AIx), a composite of wave reflection form medium-sized muscular arteries is related to the development of coronary artery disease. The aim of this study is to examine the change on central aortic waveforms in subjects between patients with metabolic syndrome and normal subjects. Using the non-invasive technique of pulse wave analysis by applantation tonometry, we investigated central aortic waveforms in 45 patients with MS and 45 matched controls. The MS was defined by NCEP-ATP III criteria. Age did not differ between the two groups. AIx was significantly elevated in patinets with MS compared with controls (21.91 ± 11.41% vs 18.14 ± 11.07%; P < 0.01). Subendocardial viability ratio (SEVR) (158.09 ± 28.69 vs 167.09 ± 30.06; P < 0.01) was significantly decreased in patients with MS compared with controls. Only the fasting glucose (r = 0.317, P = 0.03) among the components of MS and age (r = 0.424, P = 0.004) had a positive correlation with AIx. AIx increased as the number of MS components increased. These results show that the MS increased systemic arterial stiffness. Age and fasting blood glucose are independent risk factors of arterial stiffness in MS. The individual MS components, except for fasting blood glucose, do not affect arterial stiffness independently. But the clustering of MS components might interact to synergistically affect arterial stiffness. (KOREAN DIABETES J 32:522-528, 2008)

연구배경: 대사증후군은 심혈관계질환의 위험인자의 군 집으로 구성되어진 질환으로, 향후 제2형 당뇨병 및 심혈관 질환의 발병위험도가 증가되어지는 특징을 가진다. 동맥 맥 파 파형분석을 통해 측정할 수 있는 대동맥 맥파증대계수는 동맥경화증의 정도를 반영하는 지표로서 향후 심혈관질환의 위험인자에 대한 조기 인식에 도움을 준다. 본 연구는 대사 증후군군과 정상인군에서 동맥 맥파 파형의 차이를 비교분 석하고, 대사증후군의 각 요소들이 미치는 영향을 살펴보고 자 하였다. 방법: 연구대상은 건강검진을 위해 내원한 성인에서 NCEP ATP III에 의한 기준에 맞는 대사증후군군 45명과 정상인군 45명을 대상으로 하여, 신체계측, 동맥 맥파 파형 분석, 혈액검사를 실시하였다. 결과: 동맥 맥파 파형분석을 통해 대사증후군군에서 정상 인군에 비해 대동맥 맥파증대계수(AIx), 심박출지속시간 (ED)은 증가되어 있었고, 심내막하생존율 (SEVR)은 감소하 여 있었다. 대동맥 맥파증대계수와 대사증후군의 심혈관계 위험인자들 간의 연관분석에서 나이와 공복혈당이 유의한 상관관계를 보였다. 그리고 대사증후군의 요소별 수에 따른 연관분석에서 요소별 수가 증가할수록 대동맥 맥파증대계수 가 증가되었다. 결론: 대사증후군군에서 정상인군에 비해 혈관 경직도가 증가되어 있고, 대사증후군의 각 요소들이 서로 상호작용을 하여 혈관 경직도를 증가시키는 것을 보여주는 연구로, 대사증후군 환자에서 심혈관계질환의 위험도가 높음을 시사하 고 있다.

Keywords

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