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Eur Heart J:肢端肥大症与心血管结局

2021-12-05 MedSci原创 MedSci原创

肢端肥大症患者发生房颤、充血性心力衰竭和全因死亡的风险更高。房颤发生风险与肢端肥大症具有时间依赖性。

肢端肥大症的特征是生长激素(GH)和胰岛素样生长因子-1(IGF-1)慢性升高以及器官和软组织增生。2008年对16项研究的荟萃分析表明,与一般人群相比,肢端肥大症与死亡率总体增加72%相关。此外,过量的生长激素可能直接引发心脏异常。心血管疾病不仅是肢端肥大症患者最常见的合并症(80%)但也是最常见的死因(占病例的50%)。

心血管疾病是肢端肥大症的常见并发症。近日,心血管领域权威杂志Eur Heart J上发表了一篇研究文章,研究人员使用韩国全国数据调查了大型人群中肢端肥大症患者心血管疾病与死亡风险之间关系。

研究人员对肢端肥大症患者(n=1874)和年龄和性别匹配的无肢端肥大症患者(n=9370)进行了一项全国性、回顾性、观察性队列研究,平均随访时间为7.5±3.2年。该研究的结局为心肌梗塞、卒中、心房颤动、充血性心力衰竭和全因死亡。所有结局均通过Cox比例风险回归分析进行分析,同时控制年龄、性别、家庭收入、地点、2型糖尿病高血压和血脂异常。

肢端肥大症患者房颤(3.06 vs. 1.70;P=0.001)、充血性心力衰竭(3.11 vs. 1.63;P<0.001)和全因死亡(6.31 vs. 4.03;P<0.001)的发生率(每1000人次每年)高于对照者。然而,心肌梗塞和卒中的发生率在各组之间没有差异。调整协变量后,房颤[风险比(HR)为1.59;95%置信区间(CI)为1.09-2.31]、充血性心力衰竭(HR为1.54;95%CI为1.06-2.25)和全因死亡(HR为1.31;95%CI为1.01-1.69)的风险在肢端肥大症患者更高。在时间滞后敏感性分析中,肢端肥大症患者仅在诊断后的前4年内观察到与对照者更高的房颤风险(HR为3.05;95%CI为1.94-4.79)。

由此可见,肢端肥大症患者发生房颤、充血性心力衰竭和全因死亡的风险更高。房颤发生风险与肢端肥大症具有时间依赖性。

原始出处:

Sangmo Hong,et al.Acromegaly and cardiovascular outcomes: a cohort study.European Heart Journal.2021.https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab822/6449457

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    2021-12-07 zhaojie88
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    2021-12-07 slcumt
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    2021-12-06 查查佳佳

    物性饮食与多种健康益处和有利的环境影响有关。对于前列腺癌,既往

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