Жесткость сосудистой стенки у лиц молодого возраста с абдоминальным ожирением и ее связь с разными жировыми депо

Ожирение играет ключевую роль в эпидемии сахарного диабета (СД) 2-го типа и ассоциированных с ним сердечно-сосудистых и цереброваскулярных заболеваний. Большинство исследований подтверждает связь повышенной жесткости артерий с ожирением. Однако взаимосвязь разных жировых депо с одним из основных показателей жесткости сосудистой стенки - сердечно-лодыжечным сосудистым индексом (CAVI) в настоящее время изучена недостаточно. Цель исследования - оценка жесткости сосудистой стенки у лиц молодого возраста с абдоминальным ожирением (АО) без метаболического синдрома (МС) и с МС, связи жировых депо (висцерального, подкожного, периваскулярного, эпикардиального жира) с параметром жесткости CAVI. Материалы и методы. 68 человек с АО в возрасте 18-45 лет. Включенным в исследование были измерены рост, масса тела, индекс массы тела (ИМТ), окружность талии, определены биохимический анализ крови (глюкоза тощаковая и в ходе теста толерантности к глюкозе, мочевая кислота, креатинин, скорость клубочковой фильтрации), липидный профиль, инсулин, индекс инсулинорезистентности - HOMA-IR. Были выполнены: суточное мониторирование артериального давления (АД), компьютерная томография (Aquilion One Vision Edition, Toshiba, Япония) с определением подкожного, висцерального, периваскулярного, эпикардиального жира, а также рассчитывалось отношение подкожного к висцеральному жиру. Для оценки жесткости сосудистой стенки определялся CAVI на аппарате VaSera 1000 (Fukuda Denshi, Япония). Для анализа были сформированы 2 группы: лица с АО и наличием не более чем одного дополнительного фактора риска (метаболически здоровые) - 1-я группа, лица с МС (АО в сочетании с 2 и более дополнительными факторами риска) - 2-я группа, контрольную группу составили здоровые лица (n=15) без ожирения - 0-я группа. Результаты. Статистически значимого различия по CAVI между группами получено не было. Выявлены корреляционные связи CAVI с возрастом: r=0,340 (p=0,005), дневным средним систолическим АД - САДср (r=0,280, p=0,021) и средним диастолическим АД - ДАДср (r= 0,329, p=0,006), ночным САДср (r=0,233, p=0,014) и ДАДср (r=0,297, p=0,014), объемом периаортального жира (r=0,218, p=0,074). Выявлена обратная корреляционная связь CAVI с ИМТ (r=-0,279, p=0,021), подкожным жировым депо (r=-0,285, p=0,019) и отношением подкожного жира к висцеральному (r=-0,303, p=0,012). По данным многофакторного регрессионного анализа наиболее значимое влияние на CAVI оказывают возраст, САДср, ИМТ и объем периаортального жира

метаболический синдром, жировые депо, жесткость сосудов, артериальная гипертония, ожирение, избыточная масса тела

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