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首页> 外文期刊>The American Journal of Cardiology >Contribution of central and general adiposity to abnormal left ventricular diastolic function in a community sample with a high prevalence of obesity.
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Contribution of central and general adiposity to abnormal left ventricular diastolic function in a community sample with a high prevalence of obesity.

机译：在肥胖症患病率较高的社区样本中，中央肥胖和一般肥胖对左心室舒张功能异常的贡献。

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The relative independent contribution of excess adiposity, as indexed by measures of central, general, or peripheral adiposity, toward abnormal cardiac diastolic chamber function at a community level is unclear. In 377 randomly selected participants >16 years old from a community sample with a high prevalence of excess adiposity ( approximately 25% overweight and approximately 43% obese), we assessed the independent contribution of the indexes of adiposity to the variation in early-to-late (atrial) transmitral velocity (E/A). After adjustments for a number of confounders, including age, gender, pulse rate, conventional diastolic (or systolic) blood pressure, antihypertensive treatment, left ventricular mass index, and the presence of diabetes mellitus or a hemoglobin A1c level >6.1%; waist circumference was an independent predictor of a reduced E/A (p = 0.0038). Body mass index (p = 0.07), waist-to-hip ratio (p = 0.23), and skinfold thickness (p = 0.37) were not independently associated with E/A, whereas waist circumference was independently associated with E/A, even after adjustments for other adiposity indexes, including body mass index (p <0.05 to 0.005). In contrast to the effects on diastolic function, the waist circumference did not correlate with the left ventricular ejection fraction (p = 0.23). The independent relation between the waist circumference and E/A (standardized beta coefficient -0.14 +/- 0.05, p = 0.0038) was second only to age (standardized beta coefficient -0.57 +/- 0.05, p <0.0001) and similar to blood pressure (standardized beta coefficient -0.11 +/- 0.04, p = 0.0075) in the magnitude of the independent effect on E/A. The inclusion of the relative wall thickness rather than the left ventricular mass index in the regression equation produced similar outcomes. The exclusion of the left ventricular mass index and relative wall thickness from the regression equations or the inclusion of carotid-femoral pulse wave velocity or 24-hour blood pressure as confounders failed to modify the relation between waist circumference and E/A. In conclusion, the waist circumference was second only to age in the impact on an independent association with E/A in a population sample with a high prevalence of excess adiposity. This effect was not accounted for by left ventricular hypertrophy or remodeling, the 24-hour blood pressure, or arterial stiffness.
机译：目前尚不清楚过量脂肪的相对独立贡献（以中央，一般或周围脂肪的量度为指标）在社区一级对心脏舒张室功能异常的影响。在377名从16岁以上的社区样本中随机抽取的参与者中，肥胖样本的患病率很高（超重约25％，肥胖者约43％），我们评估了肥胖指数对早期至早期变异的独立贡献。晚期（心房）传输速度（E / A）。在调整了一些混杂因素后，包括年龄，性别，脉搏率，常规舒张压（或收缩压），降压治疗，左心室质量指数以及是否存在糖尿病或血红蛋白A1c水平> 6.1％;腰围是E / A降低的独立预测因子（p = 0.0038）。体重指数（p = 0.07），腰臀比（p = 0.23）和皮褶厚度（p = 0.37）与E / A无关，而腰围与E / A无关，甚至调整其他肥胖指数（包括体重指数）后（p <0.05至0.005）。与舒张功能的影响相反，腰围与左心室射血分数无关（p = 0.23）。腰围与E / A之间的独立关系（标准β系数-0.14 +/- 0.05，p = 0.0038）仅次于年龄（标准β系数-0.57 +/- 0.05，p <0.0001），与血液相似压力（标准β系数-0.11 +/- 0.04，p = 0.0075），其大小取决于对E / A的独立影响。在回归方程中包括相对壁厚而不是左心室质量指数产生了相似的结果。从回归方程中排除左心室质量指数和相对壁厚，或者由于混杂因素而包括颈动脉股脉波速度或24小时血压，均无法改变腰围与E / A之间的关系。总之，在过度肥胖症患病率较高的人群样本中，腰围仅次于年龄，仅次于与E / A的独立关联。左心室肥大或重塑，24小时血压或动脉僵硬不能解释这种作用。

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