Amin Manish G, Tighiouart Hocine, Weiner Daniel E, Stark Paul C, Griffith John L, MacLeod Bonnie, Salem Deeb N, Sarnak Mark J
Division of Clinical Care Research, Department of Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
J Am Coll Cardiol. 2004 Apr 7;43(7):1276-82. doi: 10.1016/j.jacc.2003.10.048.
The goal of this study was to investigate the relationship between hematocrit (Hct) and left ventricular mass index (LVMI) and LV hypertrophy (LVH) in subjects without known hypertension or cardiovascular disease in the Framingham Heart study.
Anemia may be an independent risk factor for cardiovascular disease in the general population. One potential explanation for this finding could be an association between Hct with LVMI or LVH.
Linear and logistic regression analyses were used to evaluate the association between Hct with LVMI and LVH. All analyses were stratified by gender and further according to menopausal status in women.
There were 1,376 men and 1,769 women who met the inclusion criteria. The mean Hct and LVMI were 46.5% and 41.9%, and 127.3 and 95.8 g/m, respectively, in men and women. After adjustment for confounders, each 3% lower Hct was associated with a 2.6 g/m higher mean LVMI in men, and a 1.8 g/m higher mean LVMI in postmenopausal women (p < 0.05). There was a significant quadratic relationship between Hct and LVMI in premenopausal women (p < 0.01). Subjects in the lowest quartile of Hct (compared with the rest of the sample) had an adjusted odds ratio of LVH of 2.0 (95% confidence interval [CI] 1.3 to 3.0) in men and 1.4 (95% CI 0.8 to 2.4) in postmenopausal women.
In a sample without known hypertension or cardiovascular disease, a lower Hct is associated with echocardiographically determined LVH in men and a small but significantly higher LVMI in men and postmenopausal women. The clinical importance of these findings remains unknown.
本研究的目的是在弗雷明汉心脏研究中,调查无已知高血压或心血管疾病的受试者的血细胞比容(Hct)与左心室质量指数(LVMI)及左心室肥厚(LVH)之间的关系。
贫血可能是一般人群中心血管疾病的独立危险因素。这一发现的一种潜在解释可能是Hct与LVMI或LVH之间存在关联。
采用线性和逻辑回归分析来评估Hct与LVMI及LVH之间的关联。所有分析均按性别分层,并进一步根据女性的绝经状态进行分层。
有1376名男性和1769名女性符合纳入标准。男性和女性的平均Hct和LVMI分别为46.5%和41.9%,以及127.3和95.8 g/m²。在调整混杂因素后,Hct每降低3%,男性的平均LVMI升高2.6 g/m²,绝经后女性的平均LVMI升高1.8 g/m²(p<0.05)。绝经前女性的Hct与LVMI之间存在显著的二次关系(p<0.01)。Hct处于最低四分位数的受试者(与样本的其余部分相比),男性LVH的调整后优势比为2.0(95%置信区间[CI]1.3至3.0),绝经后女性为1.4(95%CI 0.8至2.4)。
在一个无已知高血压或心血管疾病的样本中,较低的Hct与男性经超声心动图确定的LVH相关,与男性和绝经后女性中虽小但显著较高的LVMI相关。这些发现的临床重要性尚不清楚。