冈比亚一个城市社区成年人的左心室肥厚与胰岛素抵抗：横断面研究
Left ventricular hypertrophy and insulin resistance in adults from an urban community in The Gambia: cross-sectional study.
作者信息
Nkum Bernard Cudjoe, Micah Frank Botsi, Ankrah Theophilus C, Nyan Ousman
机构信息
Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Medicine, Royal Victoria Teaching Hospital, Banjul, The Gambia.
出版信息
PLoS One. 2014 Apr 4;9(4):e93606. doi: 10.1371/journal.pone.0093606. eCollection 2014.
OBJECTIVE
To determine the association between left ventricular hypertrophy and insulin resistance in Gambians.
DESIGN
Cross-sectional study.
SETTING
Outpatient clinics of Royal Victoria Teaching Hospital and Medical Research Council Laboratories in Banjul.
PARTICIPANTS
Three hundred and sixteen consecutive patients were enrolled from outpatient clinics. The data of 275 participants (89 males) were included in the analysis with a mean (± standard deviation) age of 53.7 (±11.9) years.
INTERVENTIONS
A questionnaire was filled and anthropometric measurements were taken. 2-D guided M-mode echocardiography, standard 12-1ead electrocardiogram, fasting insulin and the oral glucose tolerance test were performed.
MAIN OUTCOME MEASURES
The Penn formula was used to determine the left ventricular mass index, 125 g/m2 in males and 110 g/m2 in females as the cut-off for left ventricular hypertrophy. Using the fasting insulin and fasting glucose levels, the insulin resistance was estimated by the homeostatic model assessment formula. Logistic regression analysis was used to determine the association between left ventricular hypertrophy and insulin resistance.
RESULTS
The mean Penn left ventricular mass index was 119.5 (±54.3) and the prevalence of Penn left ventricular mass index left ventricular hypertrophy was 41%. The mean fasting glucose was 5.6 (±2.5) mmol/l, fasting insulin was 6.39 (±5.49) μU/ml and insulin resistance was 1.58 (±1.45). There was no association between Penn left ventricular mass index left ventricular hypertrophy and log of insulin resistance in univariate (OR = 0.98, 95% CI = 0.80-1.19, p = 0.819) and multivariate logistic regression (OR = 0.93, 95% CI = 0.76-1.15, p = 0.516) analysis.
CONCLUSION
No association was found in this study between left ventricular hypertrophy and insulin resistance in Gambians and this does not support the suggestion that insulin is an independent determinant of left ventricular hypertrophy in hypertensives.
目的
确定冈比亚人左心室肥厚与胰岛素抵抗之间的关联。
设计
横断面研究。
地点
班珠尔皇家维多利亚教学医院和医学研究理事会实验室的门诊诊所。
参与者
从门诊诊所连续招募了316名患者。对275名参与者（89名男性）的数据进行分析，其平均（±标准差）年龄为53.7（±11.9）岁。
干预措施
填写问卷并进行人体测量。进行二维引导M型超声心动图、标准12导联心电图、空腹胰岛素和口服葡萄糖耐量试验。
主要观察指标
采用Penn公式确定左心室质量指数，男性以125 g/m²、女性以110 g/m²作为左心室肥厚的临界值。利用空腹胰岛素和空腹血糖水平，通过稳态模型评估公式估算胰岛素抵抗。采用逻辑回归分析确定左心室肥厚与胰岛素抵抗之间的关联。
结果
Penn左心室质量指数的平均值为119.5（±54.3），Penn左心室质量指数左心室肥厚的患病率为41%。空腹血糖平均值为5.6（±2.5）mmol/l，空腹胰岛素为6.39（±5.49）μU/ml，胰岛素抵抗为1.58（±1.45）。在单因素（OR = 0.98，95%CI = 0.80 - 1.19，p = 0.819）和多因素逻辑回归（OR = 0.93，95%CI = 0.76 - 1.15，p = 0.516）分析中，Penn左心室质量指数左心室肥厚与胰岛素抵抗的对数之间均无关联。
结论
本研究未发现冈比亚人左心室肥厚与胰岛素抵抗之间存在关联，这并不支持胰岛素是高血压患者左心室肥厚独立决定因素的观点。
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