Gidding Samuel S, Palermo Robert A, DeLoach Stephanie S, Keith Scott W, Falkner Bonita
Nemours Cardiac Center, Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA,
Pediatr Cardiol. 2014 Feb;35(2):307-14. doi: 10.1007/s00246-013-0777-2. Epub 2013 Oct 6.
To determine if obesity, blood pressure (BP), markers of inflammation, and insulin resistance are associated with cardiac structure in African-American adolescents, a cross-sectional study was performed on a cohort oversampled for high BP and obesity. Measurements included the following: anthropometrics, BP, homeostasis model assessment (HOMA) to assess insulin resistance, high-sensitivity C-reactive protein, and plasma adipokines (adiponectin, interleukin-6, plasminogen activator inhibitor-1). Echocardiogram measurements were left-ventricular mass index (LVMI) (g/m(2.7)), LV relative wall thickness (LVRWT), left-atrial diameter index [LADI (mm/m)], and LV diastolic time intervals. LADI (r (2) = 0.25) was associated with body mass index (BMI) systolic BP (SBP) and female sex. LVMI (r (2) = 0.35) variation was associated with BMI SBP, heart rate, age, and male sex. LVRWT (r (2) = 0.05) was associated with HOMA. Tissue diastolic intervals were not associated with any risk factor. Inflammatory markers and adipokines were associated with BMI but were not independently associated with any echocardiographic measures. In African-American adolescents, BMI and SBP, but not inflammatory markers or adipokines, are important correlates of LA size and LVM.
为了确定肥胖、血压(BP)、炎症标志物和胰岛素抵抗是否与非裔美国青少年的心脏结构相关,我们对一个因高血压和肥胖而过度抽样的队列进行了一项横断面研究。测量项目包括:人体测量学指标、血压、用于评估胰岛素抵抗的稳态模型评估(HOMA)、高敏C反应蛋白和血浆脂肪因子(脂联素、白细胞介素-6、纤溶酶原激活物抑制剂-1)。超声心动图测量指标包括左心室质量指数(LVMI)(g/m(2.7))、左心室相对壁厚度(LVRWT)、左心房直径指数[LADI(mm/m)]和左心室舒张时间间期。LADI(r(2)=0.25)与体重指数(BMI)、收缩压(SBP)和女性性别相关。LVMI(r(2)=0.35)的变化与BMI、SBP、心率、年龄和男性性别相关。LVRWT(r(2)=0.05)与HOMA相关。组织舒张时间间期与任何危险因素均无关联。炎症标志物和脂肪因子与BMI相关,但与任何超声心动图测量指标均无独立关联。在非裔美国青少年中,BMI和SBP而非炎症标志物或脂肪因子是左心房大小和左心室质量的重要相关因素。