Association between insulin resistance and left ventricular hypertrophy in asymptomatic, Black, sub-Saharan African, hypertensive patients: a case-control study.
Association between insulin resistance and left ventricular hypertrophy in asymptomatic, Black, sub-Saharan African, hypertensive patients: a case-control study.
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撒哈拉以南非洲黑人无症状高血压患者胰岛素抵抗与左心室肥厚的关系：一项病例对照研究
DOI：
10.1186/s12872-020-01829-y
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发表时间：
2021-01-02
影响因子：
2.1
通讯作者：
Longo-Mbenza B
中科院分区：
文献类型：
--
作者：
Kianu Phanzu B;Nkodila Natuhoyila A;Kintoki Vita E;M'Buyamba Kabangu JR;Longo-Mbenza B
关于胰岛素抵抗（IR）和左心室肥厚（LVH）之间的关系，存在明确的信息。我们描述了黑人原发性高血压患者中肥胖、空腹胰岛素血症、胰岛素抵抗稳态模型评估（HOMA-IR）和左室肥厚之间的关系。2019年1月至12月，在刚果民主共和国金沙萨医学中心（CMK）进行了一项病例对照研究。病例组和对照组分别为伴和不伴LVH的高血压患者。分别采用简单和单变量探索性分析中的线性和logistic回归分析评估肥胖指数、缺乏体力活动、糖代谢和脂质紊乱参数与LVH之间的关系。当观察到LVH和独立变量之间存在差异时，通过使用多元线性回归和多变量分析中的条件Logistic回归研究潜在混杂因素的影响。计算决定系数（R2）、校正比值比（aOR）及其95%置信区间（95%CI），以确定LVH与独立变量之间的相关性。 88例LVH病例（52例男性）与132例对照（81例男性）进行了比较。左心室质量（LVM）的变化可以通过以下变量预测：年龄（19%）、高血压病程（31.3%）、体重指数（BMI，44.4%）、腰围（WC，42.5%）、腰围（20%）、胰岛素血症（44.8%）和HOMA-IR（43.7%）。在多元线性回归分析中，高血压病程、BMI、胰岛素血症和HOMA-IR解释了68.3%的左心室质量变异性。在逻辑回归模型中，肥胖使LVH的风险增加3倍[aOR 2.8; 95%CI（1.06-7.4）; p = 0.038]，IR使LVH的风险增加8倍[aOR 8.4; 95（3.7-15.7）; p < 0.001]。肥胖和IR似乎是撒哈拉以南非洲黑人高血压患者LVH的主要预测因素。应强调心血管危险因素的综合管理，特别注意肥胖和IR。一项前瞻性的基于人群的研究，包括使用系列成像的撒哈拉以南非洲黑人个体仍然是必不可少的，以更好地了解亚临床LV恶化随着时间的推移，并确认IR在撒哈拉以南非洲黑人高血压患者中所起的作用。
Conflicting information exists regarding the association between insulin resistance (IR) and left ventricular hypertrophy (LVH). We described the associations between obesity, fasting insulinemia, homeostasis model assessment of insulin resistance (HOMA-IR), and LVH in Black patients with essential hypertension. A case–control study was conducted at the Centre Médical de Kinshasa (CMK), the Democratic Republic of the Congo, between January and December 2019. Cases and controls were hypertensive patients with and without LVH, respectively. The relationships between obesity indices, physical inactivity, glucose metabolism and lipid disorder parameters, and LVH were assessed using linear and logistic regression analyses in simple and univariate exploratory analyses, respectively. When differences were observed between LVH and independent variables, the effects of potential confounders were studied through the use of multiple linear regression and in conditional logistic regression in multivariate analyses. The coefficients of determination (R2), adjusted odds ratios (aORs), and their 95% confidence intervals (95% CIs) were calculated to determine associations between LVH and the independent variables. Eighty-eight LVH cases (52 men) were compared against 132 controls (81 men). Variation in left ventricular mass (LVM) could be predicted by the following variables: age (19%), duration of hypertension (31.3%), body mass index (BMI, 44.4%), waist circumference (WC, 42.5%), glycemia (20%), insulinemia (44.8%), and HOMA-IR (43.7%). Hypertension duration, BMI, insulinemia, and HOMA-IR explained 68.3% of LVM variability in the multiple linear regression analysis. In the logistic regression model, obesity increased the risk of LVH by threefold [aOR 2.8; 95% CI (1.06–7.4); p = 0.038], and IR increased the risk of LVH by eightfold [aOR 8.4; 95 (3.7–15.7); p < 0.001]. Obesity and IR appear to be the primary predictors of LVH in Black sub-Saharan African hypertensive patients. The comprehensive management of cardiovascular risk factors should be emphasized, with particular attention paid to obesity and IR. A prospective population-based study of Black sub-Saharan individuals that includes the use of serial imaging remains essential to better understand subclinical LV deterioration over time and to confirm the role played by IR in Black sub-Saharan individuals with hypertension.
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影响因子：
3.7
作者：
Chau JY;Grunseit AC;Chey T;Stamatakis E;Brown WJ;Matthews CE;Bauman AE;van der Ploeg HP
通讯作者：
van der Ploeg HP
影响因子：
2.8
作者：
Desai, Chintan S.;Bartz, Traci M.;Gardin, Julius M.
通讯作者：
Gardin, Julius M.
影响因子：
4.1
作者：
Gibbs BB;Reis JP;Schelbert EB;Craft LL;Sidney S;Lima J;Lewis CE
通讯作者：
Lewis CE
影响因子：
16.2
作者：
Bonora, E;Saggiani, F;Muggeo, M
通讯作者：
Muggeo, M
影响因子：
4.9
作者：
Corry, Dalila B.;Eslami, Pirooz;Tuck, Michael L.
通讯作者：
Tuck, Michael L.