Whalley G A, Gamble G D, Doughty R N, Culpan A, Plank L, MacMahon S, Sharpe N
Department of Medicine, University of Auckland School of Medicine, New Zealand.
J Hypertens. 1999 Apr;17(4):569-74. doi: 10.1097/00004872-199917040-00016.
Left ventricular mass is associated with body size, obesity and blood pressure. Echocardiography is routinely used to estimate this parameter, which is usually indexed to body surface area to allow comparisons to be made between individuals and groups of different body size. However, in obese subjects, using left ventricular mass indexed to body surface area may inappropriately normalize left ventricular mass.
The aim of this study was to investigate the relationships between left ventricular mass and body composition and to determine the best determinants of left ventricular mass.
Echocardiography and dual-energy X-ray absorptiometry were performed in 106 subjects under primary care. Half were hypertensive subjects and the others were normotensive age- and sex-matched control subjects. Univariate correlations were studied between left ventricular mass and height, height1.5, height2.7, weight, body surface area, body mass index, waist: hip ratio, fat-free mass, bone mineral content and fat mass. Stepwise multiple linear regression was performed to determine the best determinants of left ventricular mass.
Fat-free mass was correlated with left ventricular mass (r = 0.53, P = 0.0001) and was the only independent predictor of left ventricular mass (R2 = 0.30, P= 0.0001) by multivariate analysis. Fat mass did not correlate with left ventricular mass (r= -0.005, P= 0.96). Other measures of body size, including body surface area, waist: hip ratio, bone mineral content, weight, height, height 1.5, height2.7 and body mass index all were correlated with, but were not independent determinants of, left ventricular mass.
Left ventricular mass is independently determined by fat-free mass but by no other measures of body size or composition. Specifically, left ventricular mass was neither correlated with nor determined by fat mass. None of the other measures of body size determined left ventricular mass. It may be more appropriate to index left ventricular mass to fat-free mass rather than to measures of body size which include fat mass.
左心室质量与体型、肥胖及血压相关。超声心动图常用于评估该参数，通常将其与体表面积进行指数化处理，以便在不同体型的个体和群体之间进行比较。然而，在肥胖受试者中，使用基于体表面积的左心室质量指数可能会不适当地使左心室质量标准化。
本研究旨在探讨左心室质量与身体成分之间的关系，并确定左心室质量的最佳决定因素。
对106名接受初级保健的受试者进行了超声心动图和双能X线吸收法检查。其中一半为高血压患者，另一半为年龄和性别匹配的血压正常的对照受试者。研究了左心室质量与身高、身高的1.5次方、身高的2.7次方、体重、体表面积、体重指数、腰臀比、去脂体重、骨矿物质含量和脂肪量之间的单变量相关性。进行逐步多元线性回归以确定左心室质量的最佳决定因素。
去脂体重与左心室质量相关（r = 0.53，P = 0.0001），并且通过多变量分析是左心室质量的唯一独立预测因子（R2 = 0.30，P = 0.0001）。脂肪量与左心室质量不相关（r = -0.005，P = 0.96）。其他体型测量指标，包括体表面积、腰臀比、骨矿物质含量、体重、身高、身高的1.5次方、身高的2.7次方和体重指数均与左心室质量相关，但不是左心室质量的独立决定因素。
左心室质量由去脂体重独立决定，而非由其他体型或身体成分测量指标决定。具体而言，左心室质量既不与脂肪量相关，也不由脂肪量决定。其他体型测量指标均不能决定左心室质量。将左心室质量与去脂体重进行指数化处理，而非与包括脂肪量在内的体型测量指标进行指数化处理，可能更为合适。
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