冠心病患者体成分与心肺适能的相关性

doi:10.3969/j.issn.1674-8115.2024.01.008

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (1): 72-78.doi: 10.3969/j.issn.1674-8115.2024.01.008

冠心病患者体成分与心肺适能的相关性

李阳(), 马珺, 都屹泓, 许莉, 陈菡芬, 邱训涵, 姜萌(), 卜军()

上海交通大学医学院附属仁济医院心内科，上海 200127

收稿日期:2023-05-30 接受日期:2023-12-05 出版日期:2024-01-28 发布日期:2024-02-28
通讯作者: 姜萌,卜军 E-mail:619521677@qq.com;jiangmen90919@163.com;jiangmeng90919@163.com;pujun310@hotmail.com
作者简介:李阳（1994—），男，技师，学士；电子信箱：619521677@qq.com。
基金资助:
国家自然科学基金联合基金(U21A20341);国家自然科学基金(81971570);上海市“科技创新行动计划”医学创新研究专项项目(20Y11910500);上海市“科技创新行动计划”优秀技术带头人计划(21XD1432100);上海交通大学医学院“双百人”项目(20172014)

Correlation between body compositions and cardiopulmonary fitness in patients with coronary heart disease

LI Yang(), MA Jun, DU Yihong, XU Li, CHEN Hanfen, QIU Xunhan, JIANG Meng(), PU Jun()

Department of Cardiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China

Received:2023-05-30 Accepted:2023-12-05 Online:2024-01-28 Published:2024-02-28
Contact: JIANG Meng,PU Jun E-mail:619521677@qq.com;jiangmen90919@163.com;jiangmeng90919@163.com;pujun310@hotmail.com
Supported by:
National Natural Science Foundation Joint Fund Project(U21A20341);National Natural Science Foundation of China(81971570);Medical Innovation Research Special Project of "Science and Technology Innovation Action Plan" in Shanghai(20Y11910500);Excellent Technology Leader Program Project of "Science and Technology Innovation Action Plan" in Shanghai(21XD1432100);"Two-hundred Talents" Program of Shanghai Jiao Tong University School of Medicine(20172014)

摘要/Abstract

摘要：

目的·探究冠心病患者体成分与心肺适能（cardiopulmonary fitness，CRF）的相关性。方法·选取2022年10月至2023年6月于上海交通大学医学院附属仁济医院行择期经皮冠状动脉介入治疗的冠心病患者（冠心病组）以及健康体检者（健康对照组）。所有受试者均在同一日接受心肺运动试验（cardiopulmonary exercise testing，CPET）测定CRF，以及生物电阻抗分析（bioelectrical impedance analysis，BIA）测定身体成分。结果·共纳入冠心病患者191例、健康体检者188例。2组基线特征差异均无统计学意义。与健康对照组相比，冠心病患者CRF指标均显著降低（均P<0.05）；在体成分指标中，冠心病组躯干肌肉质量（trunk muscle mass，TMM）显著低于健康对照组（P<0.01），躯干脂肪质量（trunk fat mass，TFM）显著高于健康对照组（P<0.01）。相关性分析显示，冠心病组TMM（R=0.538）、下肢肌肉质量（lower limbs muscle mass，LMM）（R=0.754）、下肢脂肪质量（lower limbs fat mass，LFM）（R=0.593）与每千克体质量峰值摄氧量（VO_2peak/kg）呈正相关（均P<0.01），TFM（R=-0.563）与VO_2peak/kg呈负相关（P<0.01）。其余体成分指标与VO_2peak/kg之间相关性均无统计学意义。依据VO_2peak/kg将冠心病患者分为低CRF组、中CRF组和高CRF组，结果发现3组患者LMM、TMM、LFM、TFM之间差异均存在统计学意义（均P<0.05）。多元线性回归分析提示年龄、性别、TMM、TFM、LMM、LFM均是冠心病患者VO_2peak/kg的相关因素。冠心病患者的VO_2peak/kg随着TMM、LMM、LFM的升高而升高，随着年龄和TFM的升高而下降，女性相比于男性患者VO_2peak/kg更低。结论·冠心病患者的CRF显著低于健康人群，TFM更高，TMM更低；在冠心病患者中，CRF与TFM呈负相关，与TMM、LMM以及LFM呈正相关。

关键词: 冠心病, 心肺适能, 体成分

Abstract:

Objective ·To explore the correlation between body compositions and cardiovascular fitness (CRF) in patients with coronary heart disease (CHD). Methods ·The CHD patients (CHD group) who underwent elective percutaneous coronary intervention treatment at Renji Hospital, Shanghai Jiao Tong University School of Medicine from October 2022 to June 2023 as well as healthy people (control group) were selected. All the participants completed cardiopulmonary exercise testing (CPET) to determine CRF and bioelectrical impedance analysis (BIA) to determine body compositions on the same day. Results ·A total of 191 patients with coronary heart disease and 188 healthy individuals were included. There was no statistically significant difference in baseline characteristics between the two groups. Compared with the control group, the CRF indicators of the CHD group were significantly reduced (all P<0.05). In terms of body composition indicators, the trunk muscle mass (TMM) of the CHD group was significantly lower than that of the control group (P<0.01), and the trunk fat mass (TFM) was significantly higher than that of the control group (P<0.01). Correlation analysis showed that TMM (R=0.538), lower limbs muscle mass (LMM) (R=0.754), and lower limbs fat mass (LFM) (R=0.593) were positively correlated with peak oxygen uptake per kilogram of bodyweight (VO_2peak/kg) in the CHD group (all P<0.01), while TFM (R=-0.563) was negatively correlated with VO_2peak/kg (P<0.01). There was no statistically significant correlation between other body composition indicators and VO_2peak/kg. According to VO_2peak/kg, the CHD patients were divided into low CRF group, medium CRF group, and high CRF group. The results showed that there were statistically significant differences in LMM, TMM, LFM, and TFM among the three groups of patients (all P<0.05). Multiple linear regression analysis suggested that age, gender, TMM, TFM, LMM, and LFM were related factors of VO_2peak/kg in the patients with CHD. The VO_2peak/kg of CHD patients increased with the increase of TMM, LMM, and LFM and the decrease of age and TFM; the female patients had lower VO_2peak/kg compared to the males. Conclusion ·The CRF of CHD patients is significantly lower than that of the healthy population, with higher TFM and lower TMM; in the CHD patients, CRF is negatively correlated with TFM and positively correlated with TMM, LMM, and LFM.

Key words: coronary heart disease (CHD), cardiopulmonary fitness (CRF), body composition

中图分类号:

R541.1

李阳, 马珺, 都屹泓, 许莉, 陈菡芬, 邱训涵, 姜萌, 卜军. 冠心病患者体成分与心肺适能的相关性[J]. 上海交通大学学报（医学版）, 2024, 44(1): 72-78.

LI Yang, MA Jun, DU Yihong, XU Li, CHEN Hanfen, QIU Xunhan, JIANG Meng, PU Jun. Correlation between body compositions and cardiopulmonary fitness in patients with coronary heart disease[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(1): 72-78.

图/表 5

参考文献 24

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Item	CHD group (n=191)	Control group (n=188)	P value
Age/year	63 (55, 68)	62 (57,70)	0.477
BMI/(kg·m^-2)	24.1 (22.3, 27.1)	22.7 (21.6, 26.8)	0.187
Male/n(%)	162 (84.8)	147 (78.2)	0.133
History of smoking/n(%)	91 (47.6)	79 (42.0)	0.311
History of alcohol consumption/n(%)	119 (62.3)	104 (55.3)	0.112
FBG/(mmol·L^-1)	5.9±1.3	5.1±1.5	0.097
TC/(mmol·L^-1)	5.2 (4.7, 5.8)	4.9 (4.6, 5.5)	0.429
LDL-C/(mmol·L^-1)	3.1 (2.7, 3.6)	3.0 (2.6, 3.5)	0.152
HDL-C/(mmol·L^-1)	1.3±0.4	1.2±0.2	0.187
SBP_rest/mmHg	122.2 (117.5, 132.9)	119.7 (115.1, 131.7)	0.075
DBP_rest/mmHg	71.2 (68.2, 78.9)	72.4 (67.3, 77.6)	0.368
Single vessel with lesions/n(%)	93 (48.7)	－	－
Multiple vessels with lesions/n(%)	98 (51.3)	－	－

Item	CHD group (n=191)	Control group (n=188)	P value
Age/year	63 (55, 68)	62 (57,70)	0.477
BMI/(kg·m^-2)	24.1 (22.3, 27.1)	22.7 (21.6, 26.8)	0.187
Male/n(%)	162 (84.8)	147 (78.2)	0.133
History of smoking/n(%)	91 (47.6)	79 (42.0)	0.311
History of alcohol consumption/n(%)	119 (62.3)	104 (55.3)	0.112
FBG/(mmol·L^-1)	5.9±1.3	5.1±1.5	0.097
TC/(mmol·L^-1)	5.2 (4.7, 5.8)	4.9 (4.6, 5.5)	0.429
LDL-C/(mmol·L^-1)	3.1 (2.7, 3.6)	3.0 (2.6, 3.5)	0.152
HDL-C/(mmol·L^-1)	1.3±0.4	1.2±0.2	0.187
SBP_rest/mmHg	122.2 (117.5, 132.9)	119.7 (115.1, 131.7)	0.075
DBP_rest/mmHg	71.2 (68.2, 78.9)	72.4 (67.3, 77.6)	0.368
Single vessel with lesions/n(%)	93 (48.7)	－	－
Multiple vessels with lesions/n(%)	98 (51.3)	－	－

Item	CHD group (n=191)	Control group (n=188)	P value
VO_2peak/kg/[mL·(kg·min)^-1]	17.9±4.1	20.5±5.7	0.001
VO_2AT/kg/[mL·(kg·min)^-1]	12.1±2.7	13.9±4.5	0.013
VO_2peak/(mL·min^-1)	1 299.3±323.8	1 483.4±408.6	0.000
O₂P/(mL·beat^-1)	10.3 (9.4, 12.1)	11.2 (9.9, 12.9)	0.025
V_E/VCO₂ slope	26.2 (23.6, 29.3)	25.2 (23.4, 29.0)	0.002
HR_peak/(beat·min^-1)	119.1±13.9	127.5±17.2	0.000
SBP_peak/mmHg	149.1 (138.5, 162.4)	152.3 (131.4, 167.5)	0.078
DBP_peak/mmHg	75.2 (68.5, 82.1)	75.1 (70.1, 85.4)	0.687
TMM/kg	22.5 (20.9, 25.2)	23.1 (19.4, 25.8)	0.007
TFM/kg	10.2±3.6	9.1±3.2	0.001
LMM/kg	14.7 (12.4, 15.9)	15.8 (14.3, 16.6)	0.222
LFM/kg	5.0 (4.3, 6.5)	5.4 (4.7, 6.3)	0.539
UMM/kg	5.8 (4.7, 6.4)	5.3 (4.5, 6.6)	0.617
UFM/kg	1.7±1.3	2.2±1.2	0.115

Item	CHD group (n=191)	Control group (n=188)	P value
VO_2peak/kg/[mL·(kg·min)^-1]	17.9±4.1	20.5±5.7	0.001
VO_2AT/kg/[mL·(kg·min)^-1]	12.1±2.7	13.9±4.5	0.013
VO_2peak/(mL·min^-1)	1 299.3±323.8	1 483.4±408.6	0.000
O₂P/(mL·beat^-1)	10.3 (9.4, 12.1)	11.2 (9.9, 12.9)	0.025
V_E/VCO₂ slope	26.2 (23.6, 29.3)	25.2 (23.4, 29.0)	0.002
HR_peak/(beat·min^-1)	119.1±13.9	127.5±17.2	0.000
SBP_peak/mmHg	149.1 (138.5, 162.4)	152.3 (131.4, 167.5)	0.078
DBP_peak/mmHg	75.2 (68.5, 82.1)	75.1 (70.1, 85.4)	0.687
TMM/kg	22.5 (20.9, 25.2)	23.1 (19.4, 25.8)	0.007
TFM/kg	10.2±3.6	9.1±3.2	0.001
LMM/kg	14.7 (12.4, 15.9)	15.8 (14.3, 16.6)	0.222
LFM/kg	5.0 (4.3, 6.5)	5.4 (4.7, 6.3)	0.539
UMM/kg	5.8 (4.7, 6.4)	5.3 (4.5, 6.6)	0.617
UFM/kg	1.7±1.3	2.2±1.2	0.115

Item	B value	β value	t value	P value
Age	-0.166	-0.214	-1.745	0.041
Gender	2.949	0.985	2.990	0.003
LFM	-0.432	-0.178	-2.517	0.023
TMM	0.792	1.239	2.336	0.038
LMM	1.411	1.279	3.012	0.008
TFM	0.995	1.750	2.096	0.009

冠心病患者体成分与心肺适能的相关性

Correlation between body compositions and cardiopulmonary fitness in patients with coronary heart disease

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