江苏高邮人群血清甘油三酯水平、代谢综合征与血管功能相关性的研究
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摘要
第一部分江苏高邮人群臂踝脉搏波传导速度、甘油三酯水平以及载脂蛋白A5基因多态性的相关性研究
1.1江苏高邮人群臂踝脉搏波传导速度与血清甘油三酯水平的相关性研究
研究显示，动脉硬化与血清甘油三酯水平的升高均与心血管疾病相关，臂踝脉搏波传导速度（brachial-ankle pulse wave velocity，baPWV）是目前公认的反映动脉硬化的良好无创性指标。本研究旨在探讨baPWV与血清甘油三酯水平的关系，总计4421例江苏高邮自然人群被纳入本研究并使用标准流行病学调查表进行问卷调查，同时进行体格检查以及baPWV、甘油三酯等血清学相关指标检测。研究结果表明baPWV与血清甘油三酯有显著相关性（r=0.18，P<0.001），进一步多元线性回归分析提示年龄、性别、体重指数、腰臀比、收缩压、心律、甘油三酯、抗高血压药物治疗以及糖尿病等因素均显著影响baPWV水平。研究结果表明在江苏高邮人群中baPWV与甘油三酯具有良好的相关性。
1.2载脂蛋白A5-1131T>C基因多态性对江苏高邮人群甘油三酯水平的影响
动物实验及人类的研究表明载脂蛋白A5（apolipoprotein A-V，APOA5）对血脂组分尤其是甘油三酯水平有显著影响，本研究主要探讨APOA5基因-1131T>C位点多态性在人群中的频率分布及其对甘油三酯水平的影响。研究共纳入高邮市八桥镇和送桥镇的4421例自然人群，通过标准流行病学调查表问卷调查并进行体格检查及甘油三酯等相关血清生化指标测定，同时提取DNA进行基因多态性测定。研究结果显示APOA5-1131T>C各基因型频率分别为TT型49.9%，TC型41.2%，CC型9.0%；等位基因T和C的频率分别为0.7和0.3。-1131C等位基因与甘油三酯水平显著相关，在校正年龄、性别、体重指数、收缩压、心率、腰臀比、抗高血压药物治疗及糖尿病等因素后，每个C等位基因增加甘油三酯水平约5%（95%CI3-8%）。本研究结果证实APOA5基因-1131位点T/C多态性与人群甘油三酯水平显著相关，其影响机制仍需进一步研究。
1.3孟德尔随机化方法在探讨臂踝脉搏波传导速度与甘油三酯水平关联性研究中的应用
观察性研究作为流行病学中最基本、应用最多的研究方法，其研究结果易受偏倚的影响以及多种混杂因素的干扰，且暴露与结局的时间顺序常被混淆，因此不能准确判别相互关联的研究对象间的真实因果关系。孟德尔随机化方法通过引入遗传基因型这一工具可助于克服观察性研究结果中偏倚、混杂、反向因果等问题的影响从而了解研究对象间的真实关系。本研究通过论文前两部分关于血清甘油三酯水平和baPWV的相关性研究结果以及载脂蛋白A5（APOA5）-1131T>C基因多态性对甘油三酯水平的影响结果，以APOA5-1131T>C位点基因多态性作为工具变量对baPWV和血清甘油三酯水平间是否存有因果关联进行了研究。研究结果显示血清甘油三酯水平与baPWV间具有显著的相关性（β=0.18，P<0.001），载脂蛋白A5-1131C等位基因与血清甘油三酯水平间亦具有显著相关性（P=0.003），但该位点各基因型与baPWV水平无关（P=0.75）。根据孟德尔随机化方法结果表明血清甘油三酯水平和baPWV的变化无直接因果关系。
第二部分臂踝脉搏波传导速度与代谢综合征的相关性研究本研究主要探讨臂踝脉搏波传导速度（baPWV）与代谢综合征（metabolic syndrome，MS）在江苏高邮人群中的关系，MS诊断标准依据美国NCEP-ATP III指南。研究共募集4445例18-74岁的受试者进行问卷调查，同时进行体格检查以及baPWV、常规血清生化指标检测等。研究结果显示江苏高邮人群中男性及女性MS患病率分别为17.2%和25.6%，baPWV与年龄、体重指数、腰围、腰臀比、血压、心率、血糖、总胆固醇、甘油三酯及低密度脂蛋白等显著相关。与未合并MS的患者相比，MS患者中baPWV水平显著增加。线性回归分析显示MS组分中的收缩压、舒张压、血糖、高密度脂蛋白、甘油三酯等成分是影响baPWV的显著因素。我们的研究证实在江苏高邮人群中MS是baPWV水平增高的独立危险因素。
Section1The association between brachial-ankle pulsewave velocity, circulating triglycerides level and APOA5-1131T>C polymorphisms in a Chinese population
1.1Correlations of brachial-ankle pulse wave velocity andcirculating triglycerides in a Chinese population
Elevated levels of circulating triglycerides and increased arterial stiffness areassociated with cardiovascular disease, and the brachial-ankle pulse wave velocity(baPWV) was well accepted as a non-invasive marker of arterial stiffness. This studywas to investigate the correlation between the baPWV and circulating triglycerides.4421subjects aged18-74years who were recruited from a Chinese population,standardized questionnaires were used to collect the subject’s medical informationand anthropometric measurements were measured, the baPWV and routinebiochemical measurements of serum including lipid profiles were performed. Thestudy results showed that baPWV was significantly associated with the levels ofcirculating triglycerides (r=0.18, P<0.001), the stepwise forward linear regressionanalyses suggested that the common logarithm of triglycerides was independentlyassociated with the baPWV (β=0.07, P<0.001) after adjusting for age, sex, body massindex, waist-to-hip ratio, systolic blood pressure, heart rate, antihypertensivetreatment, and diabetes mellitus. In conclusion, the baPWV has a positive correlationwith circulating triglycerides in a Chinese population, but if there is a casualrelationship between them cannot be determined.
1.2The-1131T>C polymorphism in the apolipoprotein A5gene is associated with elevated levels of circulatingtriglycerides in a Chinese population
Animal and human studies support the role of apolipoprotein A5(APOA5) in serumlipids profiles metabolism, especially in circulating triglycerides. We investigated theassociation between circulating triglyceride levels and the APOA5-1131T>C singlenucleotide polymorphism by examining data from4421subjects aged18-74yearswho were recruited from a Chinese population. Standardized questionnaires wereused to collect the subject’s medical information and anthropometric measurementswere measured, and routine biochemical measurements of lipid profiles wereperformed. The APO-1131T>C genotype distribution was as follows:49.9%for theTT genotype; and9.0%for the CC genotype, and the rest41.2%for the TC genotype.The minor C allele frequency of APOA5-1131T>C was0.3. The-1131C allele wasassociated with a5%(95%CI3-8%) increase in circulating triglycerides (adjusted forage, sex, body mass index, systolic blood pressure, heart rate, waist-to-hip ratio,diabetes mellitus, and antihypertensive treatment). In conclusion, the-1131T>Cpolymorphisms of the APOA5gene are associated with circulating triglycerides in aChinese population.
1.3Evaluation of circulating triglyceride levels andbrachial-ankle pulse wave velocity in a Chinese populationusing a Mendelian randomization design
Observational studies are the mostly widely used methods in epidemiology research,meantime this method has residual problems with confounding factors and reversescausality so that not be able to accurately determine the casual relationship betweenan exposure and disease. Mendelian randomization could greatly aid observationalepidemiology to avoid confounding and reverse causation by potentially allowing anunbiased estimate of the effects of gene products on disease outcomes. In thepreviously studies we demonstrated that brachial-ankle pulse wave velocity (baPWV)had a positive correlation with circulating triglycerides and also replicated theassociation between the apolipoprotein A-V (ApoA5)-1131T>C polymorphism andtriglyceride levels, here we used ApoA5genotype as an instrumental variable toinvestigate the causal relationship between baPWV and circulating triglycerides. Theresults suggested that triglyceride was significantly associated with baPWV (β=0.18,P<0.001), and ApoA5-1131C had allele specific changes in circulating triglycerides(P=0.003) and the IV based estimated baPWV, but not associated with observedbaPWV (P=0.75). Our data suggest that the association between circulatingtriglyceride levels and brachial-ankle pulse wave velocity observed in manyobservational studies reflects confounding and reverse causation, rather than a causaleffect.
Section2Brachial-ankle pulse wave velocity in relation tothe metabolic syndrome in a Chinese population
The purpose of the present study was to investigate the association betweenbrachial-ankle pulse wave velocity (baPWV) and metabolic syndrome (MS) in aChinese population. MS was defined according to the Adult Treatment Panel IIIcriteria.4445subjects aged18-74years were recruited to collect the medicalinformation and anthropometric measurements were measured, the baPWV androutine biochemical measurements of serum including lipid profiles were performed.The prevalence of MS was17.2%for men and25.6%for women respectively,baPWV showed a significant relationship with age, body mass index, waistcircumstance, waist-to-hip ratio, blood pressure, heart rate, fasting glucose, totalcholesterol, triglycerides and low-density lipoprotein cholesterol. In adjusted analysis,subjects with the metabolic syndrome had significantly higher baPWV compared tothose without. the linear regression analyses suggested that systolic blood pressure,diastolic blood pressure, serum glucose concentration, high-density lipoproteincholesterol, triglycerides were independently associated with baPWV. In conclusion,our findings indicate that the MS is strongly associated with the risk of increasedbaPWV in this Chinese population.
1.1江苏高邮人群臂踝脉搏波传导速度与血清甘油三酯水平的相关性研究
研究显示，动脉硬化与血清甘油三酯水平的升高均与心血管疾病相关，臂踝脉搏波传导速度（brachial-ankle pulse wave velocity，baPWV）是目前公认的反映动脉硬化的良好无创性指标。本研究旨在探讨baPWV与血清甘油三酯水平的关系，总计4421例江苏高邮自然人群被纳入本研究并使用标准流行病学调查表进行问卷调查，同时进行体格检查以及baPWV、甘油三酯等血清学相关指标检测。研究结果表明baPWV与血清甘油三酯有显著相关性（r=0.18，P<0.001），进一步多元线性回归分析提示年龄、性别、体重指数、腰臀比、收缩压、心律、甘油三酯、抗高血压药物治疗以及糖尿病等因素均显著影响baPWV水平。研究结果表明在江苏高邮人群中baPWV与甘油三酯具有良好的相关性。
1.2载脂蛋白A5-1131T>C基因多态性对江苏高邮人群甘油三酯水平的影响
动物实验及人类的研究表明载脂蛋白A5（apolipoprotein A-V，APOA5）对血脂组分尤其是甘油三酯水平有显著影响，本研究主要探讨APOA5基因-1131T>C位点多态性在人群中的频率分布及其对甘油三酯水平的影响。研究共纳入高邮市八桥镇和送桥镇的4421例自然人群，通过标准流行病学调查表问卷调查并进行体格检查及甘油三酯等相关血清生化指标测定，同时提取DNA进行基因多态性测定。研究结果显示APOA5-1131T>C各基因型频率分别为TT型49.9%，TC型41.2%，CC型9.0%；等位基因T和C的频率分别为0.7和0.3。-1131C等位基因与甘油三酯水平显著相关，在校正年龄、性别、体重指数、收缩压、心率、腰臀比、抗高血压药物治疗及糖尿病等因素后，每个C等位基因增加甘油三酯水平约5%（95%CI3-8%）。本研究结果证实APOA5基因-1131位点T/C多态性与人群甘油三酯水平显著相关，其影响机制仍需进一步研究。
1.3孟德尔随机化方法在探讨臂踝脉搏波传导速度与甘油三酯水平关联性研究中的应用
观察性研究作为流行病学中最基本、应用最多的研究方法，其研究结果易受偏倚的影响以及多种混杂因素的干扰，且暴露与结局的时间顺序常被混淆，因此不能准确判别相互关联的研究对象间的真实因果关系。孟德尔随机化方法通过引入遗传基因型这一工具可助于克服观察性研究结果中偏倚、混杂、反向因果等问题的影响从而了解研究对象间的真实关系。本研究通过论文前两部分关于血清甘油三酯水平和baPWV的相关性研究结果以及载脂蛋白A5（APOA5）-1131T>C基因多态性对甘油三酯水平的影响结果，以APOA5-1131T>C位点基因多态性作为工具变量对baPWV和血清甘油三酯水平间是否存有因果关联进行了研究。研究结果显示血清甘油三酯水平与baPWV间具有显著的相关性（β=0.18，P<0.001），载脂蛋白A5-1131C等位基因与血清甘油三酯水平间亦具有显著相关性（P=0.003），但该位点各基因型与baPWV水平无关（P=0.75）。根据孟德尔随机化方法结果表明血清甘油三酯水平和baPWV的变化无直接因果关系。
第二部分臂踝脉搏波传导速度与代谢综合征的相关性研究本研究主要探讨臂踝脉搏波传导速度（baPWV）与代谢综合征（metabolic syndrome，MS）在江苏高邮人群中的关系，MS诊断标准依据美国NCEP-ATP III指南。研究共募集4445例18-74岁的受试者进行问卷调查，同时进行体格检查以及baPWV、常规血清生化指标检测等。研究结果显示江苏高邮人群中男性及女性MS患病率分别为17.2%和25.6%，baPWV与年龄、体重指数、腰围、腰臀比、血压、心率、血糖、总胆固醇、甘油三酯及低密度脂蛋白等显著相关。与未合并MS的患者相比，MS患者中baPWV水平显著增加。线性回归分析显示MS组分中的收缩压、舒张压、血糖、高密度脂蛋白、甘油三酯等成分是影响baPWV的显著因素。我们的研究证实在江苏高邮人群中MS是baPWV水平增高的独立危险因素。
Section1The association between brachial-ankle pulsewave velocity, circulating triglycerides level and APOA5-1131T>C polymorphisms in a Chinese population
1.1Correlations of brachial-ankle pulse wave velocity andcirculating triglycerides in a Chinese population
Elevated levels of circulating triglycerides and increased arterial stiffness areassociated with cardiovascular disease, and the brachial-ankle pulse wave velocity(baPWV) was well accepted as a non-invasive marker of arterial stiffness. This studywas to investigate the correlation between the baPWV and circulating triglycerides.4421subjects aged18-74years who were recruited from a Chinese population,standardized questionnaires were used to collect the subject’s medical informationand anthropometric measurements were measured, the baPWV and routinebiochemical measurements of serum including lipid profiles were performed. Thestudy results showed that baPWV was significantly associated with the levels ofcirculating triglycerides (r=0.18, P<0.001), the stepwise forward linear regressionanalyses suggested that the common logarithm of triglycerides was independentlyassociated with the baPWV (β=0.07, P<0.001) after adjusting for age, sex, body massindex, waist-to-hip ratio, systolic blood pressure, heart rate, antihypertensivetreatment, and diabetes mellitus. In conclusion, the baPWV has a positive correlationwith circulating triglycerides in a Chinese population, but if there is a casualrelationship between them cannot be determined.
1.2The-1131T>C polymorphism in the apolipoprotein A5gene is associated with elevated levels of circulatingtriglycerides in a Chinese population
Animal and human studies support the role of apolipoprotein A5(APOA5) in serumlipids profiles metabolism, especially in circulating triglycerides. We investigated theassociation between circulating triglyceride levels and the APOA5-1131T>C singlenucleotide polymorphism by examining data from4421subjects aged18-74yearswho were recruited from a Chinese population. Standardized questionnaires wereused to collect the subject’s medical information and anthropometric measurementswere measured, and routine biochemical measurements of lipid profiles wereperformed. The APO-1131T>C genotype distribution was as follows:49.9%for theTT genotype; and9.0%for the CC genotype, and the rest41.2%for the TC genotype.The minor C allele frequency of APOA5-1131T>C was0.3. The-1131C allele wasassociated with a5%(95%CI3-8%) increase in circulating triglycerides (adjusted forage, sex, body mass index, systolic blood pressure, heart rate, waist-to-hip ratio,diabetes mellitus, and antihypertensive treatment). In conclusion, the-1131T>Cpolymorphisms of the APOA5gene are associated with circulating triglycerides in aChinese population.
1.3Evaluation of circulating triglyceride levels andbrachial-ankle pulse wave velocity in a Chinese populationusing a Mendelian randomization design
Observational studies are the mostly widely used methods in epidemiology research,meantime this method has residual problems with confounding factors and reversescausality so that not be able to accurately determine the casual relationship betweenan exposure and disease. Mendelian randomization could greatly aid observationalepidemiology to avoid confounding and reverse causation by potentially allowing anunbiased estimate of the effects of gene products on disease outcomes. In thepreviously studies we demonstrated that brachial-ankle pulse wave velocity (baPWV)had a positive correlation with circulating triglycerides and also replicated theassociation between the apolipoprotein A-V (ApoA5)-1131T>C polymorphism andtriglyceride levels, here we used ApoA5genotype as an instrumental variable toinvestigate the causal relationship between baPWV and circulating triglycerides. Theresults suggested that triglyceride was significantly associated with baPWV (β=0.18,P<0.001), and ApoA5-1131C had allele specific changes in circulating triglycerides(P=0.003) and the IV based estimated baPWV, but not associated with observedbaPWV (P=0.75). Our data suggest that the association between circulatingtriglyceride levels and brachial-ankle pulse wave velocity observed in manyobservational studies reflects confounding and reverse causation, rather than a causaleffect.
Section2Brachial-ankle pulse wave velocity in relation tothe metabolic syndrome in a Chinese population
The purpose of the present study was to investigate the association betweenbrachial-ankle pulse wave velocity (baPWV) and metabolic syndrome (MS) in aChinese population. MS was defined according to the Adult Treatment Panel IIIcriteria.4445subjects aged18-74years were recruited to collect the medicalinformation and anthropometric measurements were measured, the baPWV androutine biochemical measurements of serum including lipid profiles were performed.The prevalence of MS was17.2%for men and25.6%for women respectively,baPWV showed a significant relationship with age, body mass index, waistcircumstance, waist-to-hip ratio, blood pressure, heart rate, fasting glucose, totalcholesterol, triglycerides and low-density lipoprotein cholesterol. In adjusted analysis,subjects with the metabolic syndrome had significantly higher baPWV compared tothose without. the linear regression analyses suggested that systolic blood pressure,diastolic blood pressure, serum glucose concentration, high-density lipoproteincholesterol, triglycerides were independently associated with baPWV. In conclusion,our findings indicate that the MS is strongly associated with the risk of increasedbaPWV in this Chinese population.
引文
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4He L, Tang X, Song Y, Li N, Li J, Zhang Z, Liu J, Yu L, Xu H, Zhang J, Hu Y.Prevalence of cardiovascular disease and risk factors in a rural district of Beijing,China: a population-based survey of58,308residents. BMC Public Health.2012;12:34.
5He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, Wang J, Chen CS, Chen J,Wildman RP, Klag MJ, Whelton PK. Major causes of death among men and womenin China. N Engl J Med.2005;353(11):1124-34.
6胡盛寿,孔灵芝.中国心血管病报告2010:中国大百科全书出版社;2010.
7Isnard RN, Pannier BM, Laurent S, London GM, Diebold B, Safar ME.Pulsatile diameter and elastic modulus of the aortic arch in essential hypertension: anoninvasive study. J Am Coll Cardiol.1989;13(2):399-405.
8Asmar R, Benetos A, London G, Hugue C, Weiss Y, Topouchian J, Laloux B,Safar M. Aortic distensibility in normotensive, untreated and treated hypertensivepatients. Blood Press.1995;4(1):48-54.
9Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders incardiovascular disease enterprises: Part I: aging arteries: a "set up" for vasculardisease. Circulation.2003;107(1):139-46.
10Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders incardiovascular disease enterprises: Part II: the aging heart in health: links to heartdisease. Circulation.2003;107(2):346-54.
11Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovasculardisease enterprises: Part III: cellular and molecular clues to heart and arterial aging.Circulation.2003;107(3):490-7.
12Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, YamamotoY, Hori S. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vasculardamage and cardiovascular risk. Eur Heart J.2003;26(8):615-22.
13Laurent S, Boutouyrie P, Lacolley P. Structural and genetic bases of arterialstiffness. Hypertension.2005;45(6):1050-5.
14Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, andtherapy of arterial stiffness. Arterioscler Thromb Vasc Biol.2005;25(5):932-43.
15Figueiredo VN, Yugar-Toledo JC, Martins LC, Martins LB, de Faria AP, deHaro Moraes C, Sierra C, Coca A, Moreno H. Vascular stiffness and endothelialdysfunction: Correlations at different levels of blood pressure. Blood Press.2012;21(1):31-8.
16中国动脉功能无创检测临床意义评价共识专家组.动脉功能无创检测临床意义评价中国专家共识.2008.
17Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML,Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC.Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study.Circulation.2006;113(5):657-63.
18Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, IbsenH, Jeppesen J. Prognostic value of aortic pulse wave velocity as index of arterialstiffness in the general population. Circulation.2006;113(5):664-70.
19Munakata M, Nunokawa T, Yoshinaga K, Toyota T. Brachial-ankle pulse wavevelocity is an independent risk factor for microalbuminuria in patients with essentialhypertension--a Japanese trial on the prognostic implication of pulse wave velocity(J-TOPP). Hypertens Res.2006;29(7):515-21.
20Bastos JM, Bertoquini S, Polonia J. Prognostic significance of ambulatoryarterial stiffness index in hypertensives followed for8.2years: its relation with newevents and cardiovascular risk estimation. Rev Port Cardiol.2010;29(9):1287-303.
21Gomez-Marcos MA, Recio-Rodriguez JI, Rodriguez-Sanchez E,Castano-Sanchez Y, de Cabo-Laso A, Sanchez-Salgado B, Rodriguez-Martin C,Castano-Sanchez C, Gomez-Sanchez L, Garcia-Ortiz L. Central blood pressure andpulse wave velocity: relationship to target organ damage and cardiovascularmorbidity-mortality in diabetic patients or metabolic syndrome. An observationalprospective study. LOD-DIABETES study protocol. BMC Public Health.2010;10:143.
22Verbeke F, Van Biesen W, Honkanen E, Wikstrom B, Jensen PB, KrzesinskiJM, Rasmussen M, Vanholder R, Rensma PL. Prognostic value of aortic stiffness andcalcification for cardiovascular events and mortality in dialysis patients: outcome ofthe calcification outcome in renal disease (CORD) study. Clin J Am Soc Nephrol.2011;6(1):153-9.
23Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G,Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L,Rynkiewicz A, Schmieder RE, Struijker Boudier HA, Zanchetti A, Vahanian A,Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C,Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M,Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E,Lindholm LH, Manolis A, Nilsson PM, Redon J, Struijker-Boudier HA, Viigimaa M,Adamopoulos S, Bertomeu V, Clement D, Farsang C, Gaita D, Lip G, Mallion JM,Manolis AJ, O'Brien E, Ponikowski P, Ruschitzka F, Tamargo J, van Zwieten P,Waeber B, Williams B, The task force for the management of arterial hypertension ofthe European Society of H, The task force for the management of arterialhypertension of the European Society of C.2007Guidelines for the management ofarterial hypertension: The Task Force for the Management of Arterial Hypertension ofthe European Society of Hypertension (ESH) and of the European Society ofCardiology (ESC). Eur Heart J.2007;28(12):1462-536.
24中华人民共和国卫生部.中国居民营养与健康现状.中国心血管病研究.2004;2:919-922.
25王桂莲,孙艺红,傅媛媛,胡大一.北京社区居民甘油三酯异常现状分析.中华全科医师杂志.2009;8(7):443-447.
26王淼,王薇,赵冬,吴桂贤,刘静,孙佳艺,刘军,刘飒,秦兰萍,吴兆苏.北京地区青年人群心血管病危险因素10年变化趋势.心肺血管病杂志.2005;24(2):65-67.
27Aberg H, Lithell H, Selinus I, Hedstrand H. Serum triglycerides are a riskfactor for myocardial infarction but not for angina pectoris. Results from a10-yearfollow-up of Uppsala primary preventive study. Atherosclerosis.1985;54(1):89-97.
28Criqui MH, Heiss G, Cohn R, Cowan LD, Suchindran CM, Bangdiwala S,Kritchevsky S, Jacobs DR, Jr., O'Grady HK, Davis CE. Plasma triglyceride level andmortality from coronary heart disease. N Engl J Med.1993;328(17):1220-5.
29Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridemia as acardiovascular risk factor. Am J Cardiol.1998;81(4A):7B-12B.
30Jeppesen J, Hein HO, Suadicani P, Gyntelberg F. Triglyceride concentrationand ischemic heart disease: an eight-year follow-up in the Copenhagen Male Study.Circulation.1998;97(11):1029-36.
31Expert Panel on Detection E, and Treatment of High Blood Cholesterol inAdults. Executive Summary of The Third Report of The National CholesterolEducation Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment ofHigh Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA.2001;285(19):2486-97.
32Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S,Boekholdt SM, Khaw KT, Gudnason V. Triglycerides and the risk of coronary heartdisease:10,158incident cases among262,525participants in29Western prospectivestudies. Circulation.2007;115(4):450-8.
33Tirosh A, Rudich A, Shochat T, Tekes-Manova D, Israeli E, Henkin Y, KochbaI, Shai I. Changes in triglyceride levels and risk for coronary heart disease in youngmen. Ann Intern Med.2007;147(6):377-85.
34Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN,Goldberg AC, Howard WJ, Jacobson MS, Kris-Etherton PM, Lennie TA, Levi M,Mazzone T, Pennathur S. Triglycerides and cardiovascular disease: a scientificstatement from the American Heart Association. Circulation.2011;123(20):2292-333.
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1He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, Wang J, Chen CS, Chen J,Wildman RP, Klag MJ, Whelton PK. Major causes of death among men and womenin China. N Engl J Med.2005;353(11):1124-34.
2Liu T. China's health challenges. BMJ.2006;333(7564):365.
3Sai XY, He Y, Men K, Wang B, Huang JY, Shi QL, Zhang L, Li LS, Choi BC,Yan YP. All-cause mortality and risk factors in a cohort of retired military maleveterans, Xi'an, China: an18-year follow up study. BMC Public Health.2007;7:290.
4Zhang L, Qin LQ, Cui HY, Liu AP, Wang PY. Prevalence of cardiovascular riskfactors clustering among suburban residents in Beijing, China. Int J Cardiol.2011;151(1):46-9.
5He L, Tang X, Song Y, Li N, Li J, Zhang Z, Liu J, Yu L, Xu H, Zhang J, Hu Y.Prevalence of cardiovascular disease and risk factors in a rural district of Beijing,China: a population-based survey of58,308residents. BMC Public Health.2012;12:34.
6Aberg H, Lithell H, Selinus I, Hedstrand H. Serum triglycerides are a riskfactor for myocardial infarction but not for angina pectoris. Results from a10-yearfollow-up of Uppsala primary preventive study. Atherosclerosis.1985;54(1):89-97.
7Criqui MH, Heiss G, Cohn R, Cowan LD, Suchindran CM, Bangdiwala S,Kritchevsky S, Jacobs DR, Jr., O'Grady HK, Davis CE. Plasma triglyceride level andmortality from coronary heart disease. N Engl J Med.1993;328(17):1220-5.
8Austin MA, Hokanson JE, Edwards KL. Hypertriglyceridemia as acardiovascular risk factor. Am J Cardiol.1998;81(4A):7B-12B.
9Jeppesen J, Hein HO, Suadicani P, Gyntelberg F. Triglyceride concentrationand ischemic heart disease: an eight-year follow-up in the Copenhagen Male Study.Circulation.1998;97(11):1029-36.
10Expert Panel on Detection E, and Treatment of High Blood Cholesterol inAdults. Executive Summary of The Third Report of The National CholesterolEducation Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment ofHigh Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA.2001;285(19):2486-97.
11Sarwar N, Danesh J, Eiriksdottir G, Sigurdsson G, Wareham N, Bingham S,Boekholdt SM, Khaw KT, Gudnason V. Triglycerides and the risk of coronary heartdisease:10,158incident cases among262,525participants in29Western prospectivestudies. Circulation.2007;115(4):450-8.
12Tirosh A, Rudich A, Shochat T, Tekes-Manova D, Israeli E, Henkin Y, KochbaI, Shai I. Changes in triglyceride levels and risk for coronary heart disease in youngmen. Ann Intern Med.2007;147(6):377-85.
13Miller M, Stone NJ, Ballantyne C, Bittner V, Criqui MH, Ginsberg HN,Goldberg AC, Howard WJ, Jacobson MS, Kris-Etherton PM, Lennie TA, Levi M,Mazzone T, Pennathur S. Triglycerides and cardiovascular disease: a scientificstatement from the American Heart Association. Circulation.2011;123(20):2292-333.
14Isnard RN, Pannier BM, Laurent S, London GM, Diebold B, Safar ME.Pulsatile diameter and elastic modulus of the aortic arch in essential hypertension: anoninvasive study. J Am Coll Cardiol.1989;13(2):399-405.
15Asmar R, Benetos A, London G, Hugue C, Weiss Y, Topouchian J, Laloux B,Safar M. Aortic distensibility in normotensive, untreated and treated hypertensivepatients. Blood Press.1995;4(1):48-54.
16Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders incardiovascular disease enterprises: Part I: aging arteries: a "set up" for vasculardisease. Circulation.2003;107(1):139-46.
17Lakatta EG, Levy D. Arterial and cardiac aging: major shareholders incardiovascular disease enterprises: Part II: the aging heart in health: links to heartdisease. Circulation.2003;107(2):346-54.
18Lakatta EG. Arterial and cardiac aging: major shareholders in cardiovasculardisease enterprises: Part III: cellular and molecular clues to heart and arterial aging.Circulation.2003;107(3):490-7.
19Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, YamamotoY, Hori S. Brachial-ankle pulse wave velocity as a marker of atherosclerotic vasculardamage and cardiovascular risk. Eur Heart J.2003;26(8):615-22.
20Laurent S, Boutouyrie P, Lacolley P. Structural and genetic bases of arterialstiffness. Hypertension.2005;45(6):1050-5.
21Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, andtherapy of arterial stiffness. Arterioscler Thromb Vasc Biol.2005;25(5):932-43.
22Figueiredo VN, Yugar-Toledo JC, Martins LC, Martins LB, de Faria AP, deHaro Moraes C, Sierra C, Coca A, Moreno H. Vascular stiffness and endothelialdysfunction: Correlations at different levels of blood pressure. Blood Press.2012;21(1):31-8.
23Mattace-Raso FU, van der Cammen TJ, Hofman A, van Popele NM, Bos ML,Schalekamp MA, Asmar R, Reneman RS, Hoeks AP, Breteler MM, Witteman JC.Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study.Circulation.2006;113(5):657-63.
24Willum-Hansen T, Staessen JA, Torp-Pedersen C, Rasmussen S, Thijs L, IbsenH, Jeppesen J. Prognostic value of aortic pulse wave velocity as index of arterialstiffness in the general population. Circulation.2006;113(5):664-70.
25Munakata M, Nunokawa T, Yoshinaga K, Toyota T. Brachial-ankle pulse wavevelocity is an independent risk factor for microalbuminuria in patients with essentialhypertension--a Japanese trial on the prognostic implication of pulse wave velocity(J-TOPP). Hypertens Res.2006;29(7):515-21.
26Bastos JM, Bertoquini S, Polonia J. Prognostic significance of ambulatoryarterial stiffness index in hypertensives followed for8.2years: its relation with newevents and cardiovascular risk estimation. Rev Port Cardiol.2010;29(9):1287-303.
27Gomez-Marcos MA, Recio-Rodriguez JI, Rodriguez-Sanchez E,Castano-Sanchez Y, de Cabo-Laso A, Sanchez-Salgado B, Rodriguez-Martin C,Castano-Sanchez C, Gomez-Sanchez L, Garcia-Ortiz L. Central blood pressure andpulse wave velocity: relationship to target organ damage and cardiovascularmorbidity-mortality in diabetic patients or metabolic syndrome. An observationalprospective study. LOD-DIABETES study protocol. BMC Public Health.2010;10:143.
28Verbeke F, Van Biesen W, Honkanen E, Wikstrom B, Jensen PB, KrzesinskiJM, Rasmussen M, Vanholder R, Rensma PL. Prognostic value of aortic stiffness andcalcification for cardiovascular events and mortality in dialysis patients: outcome ofthe calcification outcome in renal disease (CORD) study. Clin J Am Soc Nephrol.2011;6(1):153-9.
29Schillaci G, Pirro M, Vaudo G, Mannarino MR, Savarese G, Pucci G, FranklinSS, Mannarino E. Metabolic syndrome is associated with aortic stiffness in untreatedessential hypertension. Hypertension.2005;45(6):1078-82.
30Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G,Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L,Rynkiewicz A, Schmieder RE, Struijker Boudier HA, Zanchetti A, Vahanian A,Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C,Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M,Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E,Lindholm LH, Manolis A, Nilsson PM, Redon J, Struijker-Boudier HA, Viigimaa M,Adamopoulos S, Bertomeu V, Clement D, Farsang C, Gaita D, Lip G, Mallion JM,Manolis AJ, O'Brien E, Ponikowski P, Ruschitzka F, Tamargo J, van Zwieten P,Waeber B, Williams B, The task force for the management of arterial hypertension ofthe European Society of H, The task force for the management of arterialhypertension of the European Society of C.2007Guidelines for the management ofarterial hypertension: The Task Force for the Management of Arterial Hypertension ofthe European Society of Hypertension (ESH) and of the European Society ofCardiology (ESC). Eur Heart J.2007;28(12):1462-536.
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