用骨密度计测量时机性测量斜腰腹直径可以预测死亡和心血管事件
William D Leslie1, Fatima Zarzour1, Lisa M Lix1
1University of Manitoba, Rady College of Medicine, Winnipeg, MB R3E 0W2, Canada.
JBMR plus
|March 24, 2025
概括
斜斜腹直径 (SAD),一个简单的腹部肥胖度的测量,有效地预测主要不良心血管事件 (MACEs). 这种DXA衍生的测量为心血管健康提供了优越的风险分层,与BMI相比.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 腹部脂肪是心血管疾病的危险因素.
- 腰腰腹直径 (SAD) 是一种建议的腹部肥胖度的衡量标准.
- 通常用于骨质疏松症评估的DXA扫描,可以机会性地测量SAD.
研究的目的:
- 为了确定DXA扫描期间测量的SAD是否预测主要不良心血管事件 (MACE).
- 为了将SAD/体重比率与MACEs的身体质量指数 (BMI) 的预测性能进行比较.
主要方法:
- 利用来自加拿大马尼托巴的基于人口的DXA注册表,包括72,974名40岁以上的个人.
- 将DXA数据与医疗保健数据库联系起来,以确定在平均8.4年的随访期间发生的事件MACE (全因死亡率,心肌梗塞,中风).
- 采用多变量调整模型,并使用曲线下的面积 (AUC) 和危险比率 (HRs) 分析风险分层.
主要成果:
- 与BMI相比,SAD/体重比表明MACE的风险分层优越 (AUC为0.582-0.620与BMI相比,p <0.001).
- 每次SAD/体重的SD增加都与MACE (HR 1.20),死亡 (HR 1.22),心肌梗塞 (HR 1.19) 和中风 (HR 1.17) 的风险显著增加有关.
- 在SAD/体重五分位数中观察到MACE风险的明显线性梯度,最高五分位数显示风险增加1.61倍 (调整HR).
结论:
- 在DXA测试期间随机测量SAD是MACE和死亡率的有价值和独立的预测指标.
- SAD/体重比提供了比传统的BMI指标更好的心血管风险分层.
- 这种可访问的测量可以整合到常规DXA评估中,以改善患者风险评估.
相关概念视频
01:21Sites for measuring blood pressure
Blood pressure measurement is a fundamental clinical procedure, providing crucial data for assessing cardiovascular health. Among the various sites for this measurement, the brachial and popliteal arteries are predominantly utilized due to their accessibility and the reliability of their readings. This lesson delves into the anatomical significance, methodology, and considerations of measuring blood pressure at these locations.
The Brachial Artery: Primary Site for Blood Pressure Measurement
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:30Equipments Used To Measure Blood Pressure
Direct Method
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:23Assessment of blood pressure in brachial artery(two-step method)
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
01:28Special considerations while measuring blood pressure
When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
01:17Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.