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青少年身体脂肪沉积模式及其与不良心血管预后左心室标志物的关系。

Patterns of body fat deposition in youth and their relation to left ventricular markers of adverse cardiovascular prognosis.

作者信息

Mensah G A, Treiber F A, Kapuku G K, Davis H, Barnes V A, Strong W B

机构信息

Department of Medicine, Georgia Prevention Institute, Medical College of Georgia, Augusta 30912-3710, USA.

出版信息

Am J Cardiol. 1999 Sep 1;84(5):583-8. doi: 10.1016/s0002-9149(99)00383-5.

Abstract

The patterns of body fat deposition in healthy youth and their relation to future development of cardiovascular disease remain incompletely understood. To further evaluate these patterns, we measured indirect indexes of central and general fat deposition in healthy adolescents (mean age 15.4+/-2.3 years) with family histories of hypertension. We examined the relation between these indexes and echocardiographic markers of adverse prognosis as well as the effect of gender and ethnicity. All 225 subjects (64% black and 48% female) had > or =1 biologic parent and 1 grandparent with hypertension. Skinfold thicknesses, waist-to-hip girth ratio, Quetelet index, Ponderal index, conicity, and Z score weight - Z score height were measured. Left ventricular (LV) mass, indexed LV mass, relative wall thickness (RWT), and midwall fractional shortening (MFS) were determined using echocardiography. In both black and white subjects, the adiposity indexes were significantly correlated with posterior wall thickness, total LV mass, and indexed LV mass (p <0.05 for all). Additionally, in black subjects, central adiposity was inversely related to MFS and directly related to RWT and septal thickness. General adiposity independently predicted indexed and nonindexed LV mass, whereas central adiposity predicted MFS and RWT. Compared with subjects with normal LV geometry, those with abnormal geometry were heavier and fatter based on every index of obesity (p <0.03 for all). Thus, indexes of fat deposition are significantly correlated with LV markers of adverse prognosis in healthy youth.

摘要

健康青年体内脂肪沉积模式及其与心血管疾病未来发展的关系仍未完全明了。为进一步评估这些模式,我们测量了有高血压家族史的健康青少年(平均年龄15.4±2.3岁)中心性和全身性脂肪沉积的间接指标。我们研究了这些指标与不良预后的超声心动图标志物之间的关系以及性别和种族的影响。所有225名受试者(64%为黑人,48%为女性)均有≥1名生物学父母和1名祖父母患有高血压。测量了皮褶厚度、腰臀围比、克托莱指数、 ponderal指数、锥度以及体重Z评分 - 身高Z评分。使用超声心动图测定左心室(LV)质量、左心室质量指数、相对室壁厚度(RWT)和室壁中层缩短分数(MFS)。在黑人和白人受试者中,肥胖指数均与后壁厚度、左心室总质量和左心室质量指数显著相关(所有p<0.05)。此外,在黑人受试者中,中心性肥胖与MFS呈负相关,与RWT和室间隔厚度呈正相关。全身性肥胖独立预测左心室质量指数和非指数化左心室质量,而中心性肥胖预测MFS和RWT。与左心室几何形态正常的受试者相比,几何形态异常的受试者在各项肥胖指标上体重更重、脂肪更多(所有p<0.03)。因此,脂肪沉积指标与健康青年不良预后的左心室标志物显著相关。

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