بررسی ذخیره‌ی ضربان قلب و C-Reactive Protein با حساسیت بالا در افراد با و بدون سندرم متابولیک

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، مرکز تحقیقات قلب و عروق اصفهان، پژوهشکده‌ی قلب و عروق اصفهان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 متخصص قلب و عروق، گروه قلب، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دانشیار، مرکز تحقیقات بازتوانی قلبی، پژوهشکده‌ی قلب و عروق اصفهان، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: عدم افزایش مناسب ضربان قلب متناسب با ورزش باعث پیش‌آگهی نامناسب بیماران قلبی می‌شود. علاوه بر این، سطوح فاکتورهای التهابی نظیر C-reactive protein با حساسیت بالا (hs-CRP یا High-sensitivity CRP) با آترواسکروز در ارتباط می‌باشد. در این مطالعه، این دو فاکتور در افراد با و بدون سندرم متابولیک بررسی شدند.روش‌ها: این مطالعه بر روی 123 بیمار با سندرم متابولیک و 203 بیمار بدون سندرم متابولیک که به طور تصادفی از شرکت کنندگان مطالعه‌ی کوهورت اصفهان انتخاب شده بودند، انجام گرفت. اطلاعات دموگرافیک، دور کمر، فشار خون، قد و وزن شرکت کنندگان ثبت شد. سپس، سطح سرمی تری‌گلیسرید (Triglyceride یا TG)، قند ناشتای خون ( Fasting blood sugarیا FBS)، کلسترول تام (Total cholesterol یا TC)، لیپوپروتئین با چگالی بالا (High density lipoprotein یا HDL-c)، لیپوپروتئین با چگالی پایین (Low-density lipoprotein یا LDL-c) و hs-CRP اندازه‌گیری شد. تست ورزش بر اساس پروتکل استاندارد Bruce انجام گردید و ذخیره‌ی ضربات قلب (HRR یا Heart rate reserve) ثبت شد. اطلاعات با تنظیم بر اساس سن هر شرکت کننده با استفاده از آزمون آماری Student’s t و رگرسیون خطی بررسی شد.یافته‌ها: متوسط سن در افراد با سندرم متابولیک 60/7 ± 29/54 و در افراد بدون سندرم متابولیک 61/8 ± 16/54 سال بود که تفاوت آماری معنی‌داری نداشت‌. در افراد با و بدون سندرم متابولیک به ترتیب میزان LDL-c برابر 55/29 ± 12/125 و 54/24 ± 17/116 میلی‌گرم بر دسی‌لیتر، میزان TG 49/184 ± 99/259 و 65/61 ± 38/140 میلی‌گرم بر دسی‌لیتر، میزان FBS برابر 46/48 ± 13/107 و 90/9 ± 81/81 میلی‌گرم بر دسی‌لیتر، میزان فشار خون سیستولیک برابر 15/15 ± 73/130 و 69/13 ± 06/116 میلی‌متر جیوه و میزان فشار خون دیاستولیک برابر 70/8 ± 84/28 و 69/6 ± 52/76 میلی‌متر جیوه بود و همه‌ی موارد از نظر آماری اختلاف معنی‌دار داشت. دو گروه از نظر ذخیره‌ی ضربان قلب تفاوت معنی‌داری نداشتند (027/0 = P) ولی میزان hs-CRP در گروه با سندرم متابولیک به وضوح بالاتر بود (02/0 = P).نتیجه‌گیری: ما در این مطالعه نتوانستیم ارتباطی بین ذخیره‌ی ضربات قلب و سندرم متابولیک نشان دهیم ولی ارتباط بین hs-CRP و سندرم متابولیک نشان‌دهنده‌ی افزایش میزان hs-CRP به عنوان یک فاکتور التهابی در افراد با سندرم متابولیک است. 

کلیدواژه‌ها

عنوان مقاله [English]

Comparing Heart Rate Reserve and High-Sensitivity C-Reactive Protein in Patients with and without Metabolic Syndrome

نویسندگان [English]

  • Jafar Golshahi 1
  • Yosef Khaledi 2
  • Esmaeil Aghababaei 2
  • Masoumeh Sadeghi 3
  • Mohammad Hashemi 3
  • Hamid Sanei 1
1 Associate Professor, Isfahan Cardiovascular Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Cardiologist, Department of Cardiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Associate Professor, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Absence of increase in heart rate in response to exercise indicates poor prognosis. Inflammatory factors as C-reactive protein (CRP) are associated with atherosclerosis. In this study, these two factors were compared in patients with and without metabolic syndrome.Methods: 203 individuals without and 123 individuals with metabolic syndrome were selected randomly from Isfahan Cohort Study and their demographic data, wait circumference, height and weight were recorded. Also, serum triglyceride (TG), fasting blood sugar (FBS), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), and high-sensitivity CRP (hs-CRP) levels were measured. Heart rate reserve (HRR) was determined through exercise test carried out according to the Bruce standard protocol. The age-adjusted data was analyzed by generalized linear regression and student's t test.Findings: The mean ages of individuals without and with metabolic syndrome were 54.16 ± 8.61 and 54.29 ± 7.60 years, respectively (P = 0.890). The mean LDL levels in subjects without and with the metabolic syndrome were 116.17 ± 24.04 and 120.12 ± 29.55 mg/dl while mean TG levels were 140.38 ± 61.65 and 259.99 ± 184.49 mg/dl and mean FBS levels were 81.81 ± 9.90 mg/dl and 107.13 ± 48.46 mg/dl, respectively; all the differences were statistically significant. The mean systolic blood pressure was 116.06 ± 13.69 mmHg in persons without metabolic syndrome and 130.73 ± 15.15 mmHg in patients with the syndrome. The values for mean diastolic levels in the two groups were 76.52 ± 6.69 and 82.84 ± 8.7 mmHg, respectively. Hs-CRP level in the metabolic syndrome group was significantly higher than the other group (P = 0.02) while HRR did not show significant difference in the two groups (P = 0.27).Conclusion: In our study, no relationship was documented between HRR and the metabolic syndrome. However, elevated levels of hs-CRP were recorded in patients with metabolic syndrome.

کلیدواژه‌ها [English]

  • Metabolic Syndrome
  • Exercise test
  • Heart rate reserve
  • High-Sensitivity C-Reactive Protein

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مجله دانشکده پزشکی اصفهان
دوره 32، شماره 312 - شماره پیاپی 312
بهمن و اسفند 1393
صفحه 2085-2093

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سابقه مقاله

  • تاریخ دریافت: 02 مرداد 1393
  • تاریخ بازنگری: 07 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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