在第一阶段病态肥胖背景下,COVID-19后恢复期(1-3个月)所有年龄段人群的心血管风险

O. Korkushko, V. Chyzhova, V. Shatilo, I. Samots, T. Kovtonyuk, A. Gavalko
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The subjects have been measured body weight (in kg), height (in cm), body mass index (BMI, in kg / m2), waist circumference (WC, in cm), hip circumference (HC, in cm) with the calculation of the ratio between WC and HC. For the assessment of the state of lipid metabolism, the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low - density lipoprotein cholesterol (LDL-C), triglycerides (TG) in serum venous blood were determined by standard biochemical methods with the help of automatic biochemical analyzer \"Autolab\" by \"Boehringer Mannheim\" using the reagents from company \"BIO SYSTEMS\" (Spain). Cardiovascular risk indicators were calculated - Castelli index (TC/ HDL-C) and Boizel index (TG to HDL-C), and an updated SCORE-2 scale was used. The composition of the physique was determined using the device \"OMRON\". To exclude organic cardiac pathology, arrhythmias, and conduction, a standard ECG recording on a Ucard 200 device (Ukraine) was used. 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引用次数: 0

摘要

我们研究的目的是确定40岁以上人群在COVID-19疾病后1至3个月内肥胖和超重与COVID-19之间的相关性。材料与方法:新冠肺炎后的研究对象共10人,其中年龄在40-59岁的5人,年龄在60岁及以上的5人。对照组包括21名未感染COVID-19且在调查时PCR检测为阴性的个体:年龄在40-59岁之间的个体5名,年龄在60岁及以上的个体16名。两组受试者均有心血管危险因素和代谢综合征的体征。测量受试者体重(kg)、身高(cm)、体重指数(BMI, kg / m2)、腰围(WC, cm)、臀围(HC, cm),并计算腰围与臀围之比。为了评估脂质代谢状态,在勃林格曼海姆公司自动生化分析仪“Autolab”的帮助下,采用标准生化方法测定血清静脉血中总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)的水平,试剂来自西班牙“BIO SYSTEMS”公司。计算心血管危险指标——Castelli指数(TC/ HDL-C)和Boizel指数(TG to HDL-C),并采用更新后的SCORE-2量表。使用“欧姆龙”设备确定体质的组成。为了排除器质性心脏病理、心律失常和传导,使用Ucard 200设备(乌克兰)上的标准心电图记录。研究了球结膜的微循环(裂隙灯,“蔡司”,德国)。统计数据处理使用Statistica 10.0(美国)程序进行。结果:纳入研究的受试者,可提示炎症存在的血液常规检查指标均无病理改变。根据标准心电图结果,受试者无器质性心脏病理、心律失常、传导。与未感染新冠肺炎的亚组相比,年轻代谢综合征(MS)患者的BMI具有统计学意义。在每个年龄组中,两个亚组(不包括COVID-19和COVID-19之后)的受试者都有一般肥胖率和内脏肥胖率,并结合代谢综合征的其他标志物,包括血脂异常。结果显示,新冠肺炎合并超重患者的日历年龄比无新冠肺炎合并超重患者的日历年龄有统计学意义。合并1 ~ 1级肥胖患者日历年龄明显低于未合并1级肥胖患者日历年龄。心血管风险非常高的指标是在老年人群中确定的,特别是在COVID-19之后。心血管风险高的患者发生血管疾病的可能性更大。功能毛细血管数目与动脉粥样硬化指数(r = 0.99, p <0.05)和Castelli指数(r = 0.99, p <0.05)密切相关。作为结论,我们发现肥胖与过去COVID-19后3个月后心血管风险指标增加之间存在联系。很明显,与超重患者相比,肥胖患者在更年轻的时候可能会出现更严重的COVID-19病程。新冠肺炎很可能是中年肥胖患者加速衰老的原因。然而,为了验证这一假设,有必要进行额外的检查以确定生物年龄。MS患者在COVID-19后1-3个月内检测到的变化可能是发生后综合征的基础,并证明综合致病治疗的必要性。关键词:病态肥胖;COVID-19;心血管疾病的风险;Castelli指数;Boizel指数;得两分规模;球结膜的毛细管镜检查。
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Cardiovascular risk among people of all ages during the recovery period after COVID-19 (1-3 months) in the background of morbid obesity of the first stage
The aim of our study is to determine the correlation between obesity and overweight with COVID-19 among people aged over 40 years, in the period from 1 to 3 months after COVID-19 disease. Materials and methods: the group of subjects after COVID-19 consisted of 10 people, including 5 people at the age 40-59 years and 5 people at the age 60 years and older. The control group consisted of 21 individuals without COVID-19 and had a negative PCR test at the time of the survey: 5 individuals aged 40-59 years and 16 individuals aged 60 years and older. The subjects in both groups had cardiovascular risk factors and signs of metabolic syndrome. The subjects have been measured body weight (in kg), height (in cm), body mass index (BMI, in kg / m2), waist circumference (WC, in cm), hip circumference (HC, in cm) with the calculation of the ratio between WC and HC. For the assessment of the state of lipid metabolism, the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low - density lipoprotein cholesterol (LDL-C), triglycerides (TG) in serum venous blood were determined by standard biochemical methods with the help of automatic biochemical analyzer "Autolab" by "Boehringer Mannheim" using the reagents from company "BIO SYSTEMS" (Spain). Cardiovascular risk indicators were calculated - Castelli index (TC/ HDL-C) and Boizel index (TG to HDL-C), and an updated SCORE-2 scale was used. The composition of the physique was determined using the device "OMRON". To exclude organic cardiac pathology, arrhythmias, and conduction, a standard ECG recording on a Ucard 200 device (Ukraine) was used. The microcirculation of the bulbar conjunctiva (slit lamp, "Zeiss", Germany) has been studied. Statistical data processing was performed using the program Statistica 10.0 (USA). Results: in the subjects included in the study, the indicators of general blood tests, which could indicate the presence of inflammation, were without any pathological changes. In accordance with the results of standard ECG, the subjects had no organic cardiac pathology, arrhythmia, and conduction. Younger patients with metabolic syndrome (MS) after COVID-19 had a statistically significantly higher BMI compared with the subgroup without COVID-19. Within each age group, the subjects of both subgroups (excluding COVID-19 and after COVID-19) have had general and visceral obesity rates that were combined with the other markers of metabolic syndrome, including dyslipidemia. It is shown that the calendar age of the patients with overweight after COVID-19 is statistically significantly higher than the calendar age of the patients with the overweight without COVID-19 in the anamnesis. The calendar age of the patients with the obesity of the 1-st grade after COVID-19 was significantly lower than the age of the patients without COVID-19. The indicator of very high cardiovascular risk is determined among the individuals of the senior age group, especially after COVID-19. Patients with high cardiovascular risk have more probabilities for the development of vascular disorders. A close correlation between the number of functioning capillaries and the atherogenicity index (r = 0.99, p <0.05), as well as with the Castelli index (r = 0.99, p <0.05) was found. As conclusions, we have found a connection between obesity and an increase of the indicators of cardiovascular risk 3 months later after past COVID-19. It is obvious that among people with obesity a more severe course of COVID-19 is possible at a younger age than among overweight patients. It is likely that COVID-19 may be the cause of accelerated aging in middle-aged individuals with obesity. However, to verify this assumption, it is necessary to conduct additional examinations to determine the biological age. The detected changes among the people with MS in 1-3 months after COVID-19 may be the basis for the development of post - COVID syndrome and justify the necessity for comprehensive pathogenetic treatment. Key words: morbid obesity; COVID-19; cardiovascular risk; Castelli index; Boizel index; SCORE-2 scale; capillaroscopy of the bulbar conjunctiva.
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