心脏全移植血管病变和代谢综合征之间的联系:系统性审查和元分析
Patavee Pajareya1, Watsapon Chuanchai1, Noppachai Siranart1
1Division of Cardiovascular Medicine, Center of Excellence in Arrhythmia Research, Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.
Metabolic syndrome and related disorders
|June 17, 2025
概括
代谢综合征 (MetS) 在心脏移植后显著增加心脏全移植血管病变 (CAV) 的风险. 管理肥胖和失脂症等MetS组件对于改善心脏移植接受者的结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 移植免疫学 移植免疫学
- 代谢疾病 代谢疾病
背景情况:
- 代谢综合征 (MetS) 是与心脏炎症相关的日益严重的全球健康问题.
- 心脏全移植血管病变 (CAV) 是一种主要的炎症并发症,是心脏移植 (OHT) 后移植失败的原因.
- MetS和CAV之间的联系尚未得到充分证实.
研究的目的:
- 在接受心脏移植 (OHT) 的患者中,研究代谢综合征 (MetS) 和心脏全移植血管病变 (CAV) 之间的关联.
- 确定有助于CAV发展的MetS的特定组件.
- 了解OHT之前和之后的MetS的流行情况.
主要方法:
- 进行了全面的文献搜索,直到2024年9月.
- 包括的研究分析了MetS或其组件 (肥胖,高血压,失脂症,糖尿病) 与OHT后CAV发展之间的关联.
- 结果是使用几率比率 (OR) 和危险比率 (HR) 进行合成的,使用95%的置信区间 (CI),采用随机和固定效应模型.
主要成果:
- 分析了16项涉及3,366名患者的研究.
- 在OHT前 (32%) 和OHT后 (37%) 的MetS患病率很高.
- MetS显著增加了CAV风险 (OR=1.99). 肥胖 (OR=1.54) 和失脂症 (OR=1.87) 是主要的原因. 移植后的新发糖尿病也增加了CAV风险 (HR=1.71).
结论:
- 在OHT之前和之后的MetS高患病率与增加的CAV风险有关.
- MetS的组成部分,特别是肥胖和脂质失调,与CAV有显著的关联.
- 为心脏移植接受者减少CAV,针对METS管理的有针对性的干预措施至关重要.
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