Effect of Overweight and Obesity (Defined by Asian-Specific Cutoff Criteria) on Left Ventricular Diastolic Function and Structure in a General Korean Population
Effect of Overweight and Obesity (Defined by Asian-Specific Cutoff Criteria) on Left Ventricular Diastolic Function and Structure in a General Korean Population
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DOI：
10.1253/circj.cj-16-0625
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发表时间：
2016-12-01
影响因子：
3.3
通讯作者：
Jung, Ju Young
中科院分区：
文献类型：
--
作者：
Park, Sung Keun;Ryoo, Jae-Hong;Jung, Ju Young
背景：虽然肥胖是众所周知的心血管疾病的危险因素，但在亚洲，身体质量指数（BMI）与心血管风险升高的界限仍存在争议。因此，本研究旨在调查韩国普通人群的左心室（LV）的功能和结构变化，并根据肥胖程度进行研究。方法和结果：共有31,334名明显健康的韩国成年人接受了超声心动图检查。根据亚太肥胖指南的肥胖程度将研究人群分为5组。采用多变量logistic回归分析比较5组患者左室舒张功能受损、左室重构、左室肥厚的奇比（or）和95%置信区间（CI）。以正常组为参照，左室舒张功能受损的调整后ORs （95% CI）与BMI呈正比关系[OR；体重不足为0.86 (95% CI 0.59-1.22)，超重为1.81 (95% CI 1.63-2.00)，肥胖为2.75 (95% CI 2.49-3.03)，严重肥胖为4.34 （95% CI 3.65-5.16）。左室重构和肥厚的调整后ORs与BMI成比例显著增加。结论：即使亚太指南对肥胖进行了严格的分类，BMI超过超重（>= 23 kg/m(2)）仍与左室舒张功能受损、重构和肥厚显著相关。
Background: Although obesity is a well-known risk factor for cardiovascular disease, the cutoff of body mass index (BMI) for elevated cardiovascular risk is still controversial in Asian. Thus, this study was conducted to investigate the functional and structural changes of the left ventricle (LV) according to the degree of obesity in a general Korean population.Methods and Results: A total of 31,334 apparently healthy Korean adults who underwent echocardiography were enrolled. The study population was stratified into 5 groups according to the degree of obesity classified by the AsianPacific obesity guideline. The odd ratios (ORs) with 95% confidence interval (CI) of impaired LV diastolic function, LV remodeling, and hypertrophy were compared among the 5 groups using multivariable logistic regression analysis. When the normal group was set as the reference, the adjusted ORs (95% CI) for impaired LV diastolic function showed a proportional relationship with BMI [OR; 0.86 (95% CI 0.59-1.22) in underweight, 1.81 (95% CI 1.63-2.00) in overweight, 2.75 (95% CI 2.49-3.03) in obese, and 4.34 (95% CI 3.65-5.16) in severe obese]. Adjusted ORs for LV remodeling and hypertrophy significantly increased proportional to BMI.Conclusions: Even with strict classification of obesity by the Asian-Pacific guideline, BMI of more than overweight (>= 23 kg/m(2)) was significantly associated with impaired LV diastolic function, remodeling, and hypertrophy.