CAJ | 학술논문

目的分析血清N末端B型利钠肽原(NT-proBNP)与代谢综合征(MS)之间的关系.方法北京社区居民1323名纳入了本研究,其中男性559名,女性764名.MS依据中国成人血脂异常防治指南对2004年中华医学会糖尿病学分会建议的修订定义,439例诊断为MS.以多因素logistic回归分析计算MS发病危险比值比(OR),多元线性回归分析NT-proBNP与各指标间的相关关系.结果校正性别、年龄后,MS组NT-proBNP水平低于非MS组[32.51 (29.17,36.14) ng/L比38.55 (35.73,41.50) ng/L,P=0.012]；随着MS成分由0增加至4或5个,NT-proBNP水平呈线性下降趋势,分别为45.92、37.24、35.40、31.55和33.65 ng/L(线性趋势P=0.043).MS 5个组分中,表现为腹部肥胖、较高血糖和高甘油三酯(TG)血症者,其NT-proBNP水平相应较低.校正年龄、性别、肌酐、肾小球滤过率估测值(eGFR)、低密度脂蛋白胆固醇(LDL-C)、尿酸、高敏C反应蛋白(hs-CRP)、吸烟、饮酒、运动等因素后,多元logistic回归分析显示,与NT-proBNP最低四分位水平相比,NT-proBNP的二、三、四分位水平MS发生风险OR值分别为0.782(95％ CI:0.544～1.122,P＞0.05)、0.709(95％CI:0.489～1.028,P＞0.05)和0.604(95％CI:0.405～0.900,P＜0.05).多元线性回归分析显示,NT-proBNP与女性(β=0.248,P＜0.001)、年龄(β=0.167,P＜0.001)、收缩压(β=0.154,P＜0.001)呈独立正相关,与腰围(β=-0.082,P=0.004)、舒张压(β=-0.085,P=0.015)、TG(β=-0.101,P＜0.001)、总胆固醇(β=-0.078,P=0.004)、eGFR(β=-0.150,P＜0.001)呈独立负相关.结论较高的NT-proBNP水平与MS发生风险降低相关,腹型肥胖可能是重要原因.
목적 분석혈청N말단B형리납태원(NT-proBNP)여대사종합정(MS)지간적관계.방법 북경사구거민1323명납입료본연구,기중남성559명,녀성764명.MS의거중국성인혈지이상방치지남대2004년중화의학회당뇨병학분회건의적수정정의,439례진단위MS.이다인소logistic회귀분석계산MS발병위험비치비(OR),다원선성회귀분석NT-proBNP여각지표간적상관관계.결과 교정성별、년령후,MS조NT-proBNP수평저우비MS조[32.51 (29.17,36.14) ng/L비38.55 (35.73,41.50) ng/L,P=0.012]；수착MS성분유0증가지4혹5개,NT-proBNP수평정선성하강추세,분별위45.92、37.24、35.40、31.55화33.65 ng/L(선성추세P=0.043).MS 5개조분중,표현위복부비반、교고혈당화고감유삼지(TG)혈증자,기NT-proBNP수평상응교저.교정년령、성별、기항、신소구려과솔고측치(eGFR)、저밀도지단백담고순(LDL-C)、뇨산、고민C반응단백(hs-CRP)、흡연、음주、운동등인소후,다원logistic회귀분석현시,여NT-proBNP최저사분위수평상비,NT-proBNP적이、삼、사분위수평MS발생풍험OR치분별위0.782(95％ CI:0.544～1.122,P＞0.05)、0.709(95％CI:0.489～1.028,P＞0.05)화0.604(95％CI:0.405～0.900,P＜0.05).다원선성회귀분석현시,NT-proBNP여녀성(β=0.248,P＜0.001)、년령(β=0.167,P＜0.001)、수축압(β=0.154,P＜0.001)정독립정상관,여요위(β=-0.082,P=0.004)、서장압(β=-0.085,P=0.015)、TG(β=-0.101,P＜0.001)、총담고순(β=-0.078,P=0.004)、eGFR(β=-0.150,P＜0.001)정독립부상관.결론 교고적NT-proBNP수평여MS발생풍험강저상관,복형비반가능시중요원인.
Objective To explore the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and metabolic syndrome (MS).Methods A total of 1323 Beijing residents (559male) were investigated.MS was defined by the modified 2004 Chinese Diabetes Society criteria and 439 cases were diagnosed as MS according to this criteria.Multivariate logistic regression analysis was used to estimate the odds ratios (OR) of MS.Multiple linear regression analysis was performed to analyze the association between NT-proBNP and characteristic variables.Results NT-proBNP was significantly lower in MS group compared to non-MS group [32.51 (29.17,36.14) ng/L vs.38.55(35.73,41.50) ng/L,P =0.012] after adjusted for age and gender.NT-proBNP level decreased with the presence of MS components(from 0 to 4 or 5) (45.92,37.24,35.40,31.55 and 33.65 ng/L respectively,P =0.043 for linear trend).Among the components,groups with larger waist circumference,higher fasting glucose and triglycerides were associated with lower NT-proBNP level.After adjustment for potential confounders,compared with the lowest NT-proBNP quartile,the adjusted odds ratio of the second,third and fourth quartile for having MS were 0.782 (95 ％ CI: 0.544-1.122,P ＞ 0.05),0.709 (95 ％ CI: 0.489-1.028,P ＞ 0.05),0.604 (95 ％ CI:O.405-0.900,P ＜0.05),respectively.Multiple linear regression analysis showed that female gender(β =0.248,P ＜0.001),age(β =0.167,P ＜ 0.001),systolic blood pressure (β =0.154,P ＜ 0.001) were positively related to NT-proBNP level while waist circumference (β =-0.082,P =0.004),diastolic blood pressure (β =-0.085,P =0.015),triglycerides (β =-0.101,P ＜ O.001),total cholesterol (β =-0.078,P =0.004),eGFR (β =-0.150,P ＜ 0.001) were negatively corelated to NT-proBNP level.Conclusion In this cohort,higher serum NT-proBNP concentration is associated with lower incidence of metabolic syndrome.