Comparison of cardiac structure and function in American Indians with and without the metabolic syndrome (The Strong Heart study)
Comparison of cardiac structure and function in American Indians with and without the metabolic syndrome (The Strong Heart study)
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DOI：
10.1016/j.amjcard.2003.09.009
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发表时间：
2004-01-01
影响因子：
2.8
通讯作者：
de Simone, G
中科院分区：
文献类型：
--
作者：
Chinali, M;Devereux, RB;de Simone, G
代谢综合征（MS）与心血管风险有关。最近，成人治疗小组（ATP）III为MS的定义提供了新的标准。我们分析了MS对心脏结构和功能的影响，以及ATP III定义的MS的5种不同组分与临床前疾病的心脏标志物的独立关联。对612名ATP不明确型MS的非糖尿病参与者和824名非MS参与者进行超声心动图检查。MS参与者更多为女性（p < 0.001），与非MS参与者相比年龄相似。在控制混杂因素后，MS参与者的左心室更大。(IV)尺寸、质量和相对壁厚以及左心房直径（所有p均小于或等于0.01），LV肥大的患病率较高（p < 0.001），射血分数较低（p < 0.05），室壁中部缩短（p < 0.001），二尖瓣E/A比值（p < 0.05）。在多元回归模型中，高血压（BP）和腹部肥胖是MS中与LV直径增加相关的唯一组分;仅高BP与LV质量增加和IV肥大的发生率相关（均p < 0.001）。当血压升高至正常水平而无高血压时，MS表现出与无MS的高血压参与者相似的LV几何结构。因此，异常LV几何结构和功能与MS相关。即使在无传统定义的高血压的情况下，血压升高也是与临床前疾病的心脏标志物最密切相关的MS组分。(C)2003年，Excerpta Medica，Inc.
The metabolic syndrome (MS) is linked to cardiovascular risk. Recently, the Adult Treatment Panel (ATP) III provided new criteria for the definition of the MS. We analyzed the impact of the MS on cardiac structure and function and the independent association of the 5 different components of the ATP Ill-defined MS with cardiac markers of preclinical disease. Echocardiographic examination was performed in 612 nondiabetic participants with ATP Ill-defined MS and in, 824 participants without the MS. Participants with the MS were more often women (p < 0.001) and had similar ages compared with those without the MS. After controlling for confounders, participants with the MS had greater left ventricular. (IV) dimension, mass, and relative wall thickness, and left atrial diameter (all p less than or equal to 0.01), and a higher prevalence of LV hypertrophy (p < 0.001), with lower ejection fraction (p < 0.05), midwall shortening (p < 0.001), and mitral E/A ratio (p < 0.05) than participants who did not have the MS. In multiple regression modeling, high blood pressure (BP) and abdominal obesity were the only components of the MS associated with increased LV diameter; only high BP was associated with increased LV mass and prevalence of IV hypertrophy (both p < 0.001). When high to normal BP was present in the absence of hypertension, the MS exhibited LV geometry similar to'hypertensive participants without the MS. Therefore, abnormal LV geometry and function are related to the MS. Increased BP is the component of the MS most strongly associated with cardiac markers of preclinical disease, even in the absence of traditionally defined hypertension. (C) 2003 by Excerpta Medica, Inc.