Visit-to-visit variability of metabolic parameters and risk of heart failure: A nationwide population-based study
Visit-to-visit variability of metabolic parameters and risk of heart failure: A nationwide population-based study
复制标题
DOI：
10.1016/j.ijcard.2019.06.035
复制
发表时间：
2019-10-15
影响因子：
3.5
通讯作者：
Oh, Seil
中科院分区：
文献类型：
--
作者：
Kwon, Soonil;Lee, So-Ryoung;Oh, Seil
背景：本研究探讨了收缩压（BP）、体重指数（BMI）、空腹血糖（FBG）和总胆固醇水平（TC）四个代谢参数的变异性对心衰风险的影响。代谢参数变异性对心力衰竭（HF）风险的影响尚不清楚。方法：我们研究了在2009年和2012年期间在韩国国民健康保险公司接受>= 3次健康检查的年龄>= 40岁的个体，以及那些没有高血压、糖尿病或血脂异常的个体。每次就诊均测量BP、BMI、FBG和TC。我们使用可变性独立于均值（VIM）方法定义了每个参数的可变性。根据四分位数将VIMs分为四组。每个受试者的代谢变异性（MV）评分被定义为最高四分位数的VIMs数量。结果：在3820191名受试者中，17253名（0.45%）在平均5.3 +/- 1.1年的随访期间发生心衰。各参数的高变异性与HF风险增加相关，随MV评分的增加而增加。多变量调整后，与MV评分= 0的受试者相比，MV评分= 1-4的受试者HF风险增加（校正HR [95% CI]， MV评分= 1时为1.15 [1.10-1.19]，MV评分= 2时为1.33 [1.28-1.39]，MV评分= 3时为1.48 [1.40-1.57]，MV评分= 4时为1.74 [1.55-1.96]）[p-for-trend]
Background: This study examined the effects of variability of four metabolic parameters, namely systolic blood pressure (BP), body mass index (BMI), fasting blood glucose (FBG), and total cholesterol level (TC) on the risk of HF. The effects of metabolic parameter variability on the risk of heart failure (HF) remain unclear.Methods: We studied individuals aged >= 40 years who had undergone >= 3 health check-ups under the Korean National Health Insurance Corporation during 2009 and 2012, and those who did not have hypertension, diabetes, or dyslipidemia. BP, BMI, FBG, and TC were measured at every visit. We defined the variability of each parameter using the variability independent of the mean (VIM) method. VIMs were categorized into four groups according to quartiles. The metabolic variability (MV) score for each subject was defined as the number of VIMs in the highest quartile.Results: Among the 3,820,191 subjects, 17,253 (0.45%) had incident HF during a mean 5.3 +/- 1.1 years of follow-up. High variability of each parameter was associated with increased HF risk, which increased according to the MV score. After multivariable adjustment, compared to subjects with MV score = 0, subjects with MV score = 1-4 had an increased risk of HF (adjusted HR [95% CI], 1.15 [1.10-1.19] for MV score = 1, 1.33 [1.28-1.39] for MV score = 2, 1.48 [1.40-1.57] for MV score = 3, 1.74 [1.55-1.96] for MV score = 4 [p-for-trend