Association between diabetes mellitus and left ventricular hypertrophy in a multiethnic population
Association between diabetes mellitus and left ventricular hypertrophy in a multiethnic population
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DOI：
10.1016/j.amjcard.2008.02.082
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发表时间：
2008-06-15
影响因子：
2.8
通讯作者：
Di Tullio, Marco R.
中科院分区：
文献类型：
--
作者：
Eguchi, Kazuo;Boden-Albala, Bernadette;Di Tullio, Marco R.
2型糖尿病（T2 DM）是否与左心室（LV）质量增加相关，而与体型无关，目前仍有争议。我们在多种族队列中检验了T2 DM与LV质量独立相关的假设。在北方曼哈顿研究（NOMAS）队列样本中，通过经胸超声心动图研究了总计1，932例受试者（67.9 ± 9.6岁，769例男性和1，163例女性，443例糖尿病患者和1，489例非糖尿病患者），并计算了LV质量。LV肥大定义为LV质量的上四分位数。在调整年龄、性别、种族、体重指数（BMI）、收缩压、教育、冠状动脉疾病史、体力活动和饮酒后，使用多变量模型评估T2 DM与LV质量的相关性。糖尿病组的左心室质量（189 +/- 60 vs 174 +/- 59 g，p < 0.0001）、BMI和收缩压均高于非糖尿病组，而两组之间的年龄和性别分布相似。在多变量分析中，T2 DM与LV质量增加独立相关（p = 0.03）。存在T2 DM与LV肥大风险增加相关（校正比值比1.46，95%置信区间1.13 - 1.88，p = 0.004）。尽管未观察到T2 DM和BMI之间对LV肥大的相互作用（p = 0.6），但T2 DM和腰围之间对LV肥大存在显著相互作用（p = 0.01）。总之，在该多种族样本中，T2 DM与LV肥大增加独立相关，与各种协变量无关。T2 DM的存在使LV肥大的风险增加约1.5倍，并且可能与中心性肥胖相互作用。(c)2008年爱思唯尔公司All rights reserved.
It is still controversial whether type 2 diabetes mellitus (T2DM) is associated with increased left ventricular (LV) mass independent of body size. We tested the hypothesis that T2DM is independently associated with LV mass in a multiethnic cohort. In the Northern Manhattan Study (NOMAS) cohort sample, a total of 1,932 subjects (67.9 +/- 9.6 years, 769 men and 1,163 women, 443 with DM and 1,489 without DM) were studied by transthoracic echocardiography, and LV mass was calculated. LV hypertrophy was defined as the upper quartile of LV mass. Multivariable models were used to assess the association of T2DM with LV mass after adjusting for age, gender, race, body mass index (BMI), systolic blood pressure, education, history of coronary artery disease, physical activity, and alcohol consumption. LV mass (189 +/- 60 vs 174 +/- 59 g, p < 0.0001), BMI, and systolic blood pressure were higher in the DM group than in the non-DM group, whereas age and gender distributions were similar between groups. In multivariable analysis, T2DM was independently associated with increased LV mass (p = 0.03). Presence of T2DM was associated with increased risk of LV hypertrophy (adjusted odds ratio 1.46, 95% confidence interval 1.13 to 1.88, p = 0.004). Although no interactions were observed between T2DM and BMI on LV hypertrophy (p = 0.6), there was a significant interaction between T2DM and waist circumference on LV hypertrophy (p = 0.01). In conclusion, T2DM was independently associated with increased LV hypertrophy independent of various covariates in this multiethnic sample. Presence of T2DM increased the risk of LV hypertrophy by about 1.5-fold, and it possibly interacted with central obesity. (c) 2008 Elsevier Inc. All rights reserved.