高血压患者中2型糖尿病与主动脉根部内径呈负相关。

Inverse association between type 2 diabetes and aortic root dimension in hypertensive patients.

作者信息

Nardi Emilio, Mulè Giuseppe, Nardi Chiara, Geraci Giulio, Averna Maurizio

机构信息

Dipartimento Biomedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Italy.

出版信息

Int J Cardiol. 2017 Feb 1;228:233-237. doi: 10.1016/j.ijcard.2016.11.163. Epub 2016 Nov 9.

DOI:10.1016/j.ijcard.2016.11.163

PMID:27865191

Abstract

BACKGROUND

Some data support the concept that aortic root diameter (ARD) in hypertension may be regarded as a marker of subclinical organ damage. The impact of type 2 diabetes mellitus (DM) on cardiac structure and function is known, although the relationship between DM and ARD is not clear. The aim of our study was to evaluate the influence of DM on ARD in hypertensive patients.

METHODS

We enrolled 1693 hypertensive patients (aged 63.7±9.6years). The population was divided into two groups: the first one with DM (n=747) and the second one without DM (n=946). ARD was measured by echocardiography at level of Valsalva's sinuses using echocardiography M-mode tracings. It was considered as absolute measure and normalized to height (ARD/H) and body surface area (ARD/BSA). Left ventricular mass index (LVMI) and some parameters of systolic and diastolic function have been valued by means of echocardiography and tissue Doppler imaging.

RESULTS

The DM group was characterized by more elevated values of LVMI and a worst systolic and diastolic function. ARD value was significantly lower in DM group in comparison to patients without DM only when indexed for BSA (ARD/BSA=18.7±2.3mm/m vs 18.3±2.0mm/m, p=0.01). This difference remained statistically significant, even after correction by age, sex and BMI (p=0.01). A multivariate linear regression analysis demonstrated an inverse relationship between DM and ARD/BSA after correction for potential confounders (β=0.10, p<0.001).

CONCLUSIONS

Our results confirm the hypothesis of a protective role of DM on aortic root dilatation.

摘要

背景

一些数据支持这样的概念，即高血压患者的主动脉根部直径（ARD）可被视为亚临床器官损伤的标志物。2型糖尿病（DM）对心脏结构和功能的影响是已知的，尽管DM与ARD之间的关系尚不清楚。我们研究的目的是评估DM对高血压患者ARD的影响。

方法

我们纳入了1693例高血压患者（年龄63.7±9.6岁）。将人群分为两组：第一组为患有DM的患者（n = 747），第二组为未患DM的患者（n = 946）。使用超声心动图M型描记法在主动脉窦水平通过超声心动图测量ARD。将其视为绝对测量值，并根据身高（ARD/H）和体表面积（ARD/BSA）进行标准化。通过超声心动图和组织多普勒成像评估左心室质量指数（LVMI）以及收缩和舒张功能的一些参数。

结果

DM组的特征是LVMI值更高，收缩和舒张功能更差。仅在根据体表面积进行指数化时，DM组的ARD值显著低于未患DM的患者（ARD/BSA = 18.7±2.3mm/m² 对 18.3±2.0mm/m²，p = 0.01）。即使在按年龄、性别和BMI校正后，这种差异仍具有统计学意义（p = 0.01）。多变量线性回归分析表明，在对潜在混杂因素进行校正后，DM与ARD/BSA之间存在负相关关系（β = 0.10，p < 0.001）。