生长激素和胰岛素样生长因子-1与肥胖患者冠状动脉疾病预后的关系

Q3 Medicine

Obesity and Metabolism Pub Date : 2014-10-26 DOI:10.14341/OMET2014433-40

O. Shpagina, I. Bondarenko, M. Kuklina, O. V. Manchenko, G. Kolesnikova, N. Goncharov

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引用次数: 1

摘要

介绍。肥胖患者冠状动脉粥样硬化和慢性心力衰竭(CHF)进展迅速，长期预后比体重正常的患者差。目的:探讨GH和IGF-1在评价肥胖患者心血管危险中的预后意义。材料与方法。研究对象为体重超重或轻度肥胖(体重指数(BMI) 28.69±3.6 kg/ m2)的男性75名，平均年龄55.31±6.32岁。1组患者45例(年龄56.4±6.29岁，BMI 28.69±3.69 kg/ m2，血压124±10.18/80±4.59 mm Hg)行冠状动脉造影。2组患者30例，平均年龄53.6±6.1岁，BMI 28.68±3.52 kg/ m2，血压128±9/83±6.81 mm Hg，经跑步机试验排除冠心病。第二组观察冠状动脉钙评分。所有参与者均接受糖耐量(IGT)、甘油三酯(TG)、IGF-1和GH、LPHD、LPLD评估，并通过超声心动图评估心室几何形状。结果。两组患者在年龄、体重指数和血压方面没有差异。各组间IGF-1水平无显著差异。1组患者常出现高循环IGF-1水平(χ =0.018)。高IGF-1与肥胖(p=0.033)、吸烟(p=0.049)、高血压(p=0.002)、舒张末期尺寸(p=0.045)有统计学意义的关联。1组GH低于2组(p=0.046)。血清GH水平与EF (p=0.023)和E/A (p=0.043)呈正相关，与左房壁厚度(p=0.025)和冠状动脉钙评分(p=0.005)呈负相关。结论:1。IGF-1可能是评估肥胖患者冠心病和CHF预后的有用指标。2. 相对生长激素缺乏更常与肥胖患者的严重CAD相关。

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Growth hormone and insulin-like growth factor-1 in prognosis coronary artery disease in patients with obesity

Introduction. In patients with obesity coronary atherosclerosis and chronic heart failure (CHF) progress rapidly and have a worse long-term prognosis than those with normal weight. Objective: To investigate the prognostic significance of GH and IGF-1 in the evaluation of cardiovascular risk in patients with obesity. Materials and Methods. The study included 75 men (mean age 55.31±6.32 years), which are overweight or have mild obesity (body mass index (BMI) 28.69±3.6 kg/m 2 ). Group 1 included 45 patients (age 56.4±6.29 years, BMI 28.69±3.69 kg/m 2 , blood pressure 124±10.18/80±4.59 mm Hg) who underwent coronary angiography. Group 2 included 30 patients (mean age 53.6 ± 6.1 years, BMI 28.68±3.52 kg/m 2 , blood pressure 128±9/83±6.81 mm Hg), CAD who are excluded by treadmill test. The coronary artery calcium score was assessed in group 2. All participants were evaluated impaired glucose tolerance (IGT), triglycerides (TG), IGF-1 and GH, LPHD, LPLD, geometry of the heart chambers was assessed by echocardiography. Results. Patients in both groups did not differ in age, BMI, blood pressure. IGF-1 levels were not significantly different among the study groups. High circulating IGF-1 levels were frequently observed in group 1 (р=0.018). A statistically significant association of high IGF-1 observed with obesity (p=0.033), smoking (p=0.049), hypertension (p=0.002), end-diastolic dimension (p=0.045). GH was lower in group 1 compared with group 2 (p=0.046). Serum levels of GH are positively associated with EF (p=0.023) and E/A (p=0.043) and negatively associated with left atrial wall thickness (p=0.025) and coronary artery calcium score (p=0.005). Conclusion: 1. IGF-1 may be a useful indicator to assess the prognosis of CAD and CHF in patients with obesity. 2. Relative GH deficiency was more often associated with severe CAD in patients with obesity.

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来源期刊

Obesity and Metabolism Medicine-Internal Medicine

CiteScore

1.30

自引率

0.00%

发文量

期刊介绍： Journal "Obesity and Metabolism" is a multidisciplinary forum for clinical and applied research in the field of biochemistry, physiology, pathophysiology, genetics, nutrition, as well as molecular, metabolic, psychological and epidemiological aspects of obesity and metabolism. The main subject "Metabolism" reviewed in the journal, includes fat, carbohydrate, protein, bone, fluid and electrolyte and other types of metabolism in the spectrum of pathology of the endocrine system. The priority direction of Journal "Obesity and Metabolism" is publishing modern high-quality original research on the effectiveness of new and existing treatments in any aspect of metabolic and endocrine diseases. Pre-clinical pharmacology, pharmacokinetics studies, meta-analyzes, addressed to drug safety and tolerance are also welcome for publication in the journal "Obesity and metabolism." Journal "Obesity and Metabolism" announces review articles that are balanced, clear and offer the reader a modern and critical analysis of the literature on the subject of the magazine. Case reports, and lecture materials are also published for highlighting for practitioners new approaches to diagnosis and treatment of patients with metabolic disorders and obesity.