Guo Xiaofan, Li Zhao, Guo Liang, Yu Shasha, Yang Hongmei, Zheng Liqiang, Pan Guowei, Zhang Yonghong, Sun Yingxian, Pletcher Mark J
Department of Cardiology, the First Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Am J Cardiol. 2017 Apr 15;119(8):1199-1204. doi: 10.1016/j.amjcard.2016.12.033. Epub 2017 Jan 25.
Although obesity and the metabolic syndrome (MS) often co-occur, many obese (OB) subjects have a favorable metabolic profile. It is unclear whether these factors independently influence cardiac electrophysiology including prolongation of the QT interval. We examined associations among obesity, MS, and prolonged corrected QT (QTc) interval in a large sample of Chinese research participants aged ≥35 years recruited from rural areas of Liaoning Province during 2012 to 2013. Of the 11,209 participants, 6,364 (56.8%) were nonobese and metabolically healthy (OB-/MS-), 2,853 (25.5%) were OB-/MS+, 493 (4.4%) were OB+/MS-, and 1,499 (13.4%) were OB+/MS+. Mean (±SD) QTc intervals were higher in OB-/MS+ (436.3 ± 24.3) and OB+/MS+ (436.6 ± 25.9) participants but not OB+/MS- participants (425.4 ± 24.0) than in OB-/MS- participants (426.8 ± 21.5, p <0.001), and the prevalence of QTc prolongation was higher in OB-/MS+ and OB+/MS+ participants (adjusted odds ratios [aOR] 1.68, 95% confidence interval [CI] 1.52 to 1.85; aOR 1.92, 95% CI 1.69 to 2.17, respectively) compared with OB-/MS- group but not in OB+/MS- participants (aOR 0.92, 95% CI 0.73 to 1.15). Prevalence increased with each MS component (aOR 1.27, 95% CI 1.22 to 1.32) but not with body mass index (aOR 1.01, 95% CI 0.99 to 1.02). In conclusion, prolonged QTc interval is associated with the MS and not independently associated with obesity.
虽然肥胖症与代谢综合征（MS）常常同时出现，但许多肥胖（OB）个体却有着良好的代谢状况。目前尚不清楚这些因素是否会独立影响心脏电生理，包括QT间期延长。我们对2012年至2013年从辽宁省农村地区招募的年龄≥35岁的大量中国研究参与者进行了研究，以探究肥胖、MS与校正QT（QTc）间期延长之间的关联。在11,209名参与者中，6,364名（56.8%）为非肥胖且代谢健康（OB-/MS-），2,853名（25.5%）为OB-/MS+，493名（4.4%）为OB+/MS-，1,499名（13.4%）为OB+/MS+。OB-/MS+组（436.3±24.3）和OB+/MS+组（436.6±25.9）参与者的平均（±标准差）QTc间期高于OB-/MS-组参与者（426.8±21.5），而OB+/MS-组参与者（425.4±24.0）的平均QTc间期并不高于OB-/MS-组参与者（p<0.001）。与OB-/MS-组相比，OB-/MS+组和OB+/MS+组参与者QTc延长的患病率更高（校正优势比[aOR]分别为1.68，95%置信区间[CI]为1.52至1.85；aOR为1.92，95%CI为1.69至2.17），而OB+/MS-组参与者则不然（aOR为0.92，95%CI为0.73至1.15）。患病率随MS的每个组分增加（aOR为1.27，95%CI为1.22至1.32），但不随体重指数增加（aOR为1.01，95%CI为0.99至1.02）。总之，QTc间期延长与MS相关，而与肥胖并无独立关联。
