Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, Incheon, Korea.
Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Int J Med Sci. 2017 Nov 2;14(13):1375-1381. doi: 10.7150/ijms.21393. eCollection 2017.
This study was performed to determine the clinical usefulness of measurement of visceral fat area (VFA) using bioimpedance analysis in relation with left ventricular hypertrophy (LVH), diastolic dysfunction parameters, and decreased estimated glomerular filtration rate (eGFR). A cross-sectional analysis was performed on 1028 patients with eGFR≥60 ml/min/1.73m, aged 40 - 64 years, and who underwent routine health check-ups. Subjects were divided into tertiles based on their VFA. Associations of VFA with echocardiographic parameters and eGFR were evaluated. Across the VFA teriltes, there was a significant trend for increasing left ventricular mass index (LVMi), left atrial diameter (LAD), and ratio of early mitral inflow velocity to peak mitral annulus velocity (E/E' ratio) and that for decreasing ratio of early to late mitral inflow peak velocities (E/A ratio) and eGFR. In multivariate linear regression analysis, log-transformed VFA was significantly associated with increased LVMi, LAD, and E/E' ratio, and with decreased E/A ratio and eGFR. After adjustment for body mass index, log-transformed VFA remained as a significant determinant for E/A ratio. VFA may be associated with LV structure and diastolic function, and decreased eGFR in middle-aged adults with normal or mildly impaired renal function.
本研究旨在确定生物阻抗分析测量内脏脂肪面积(VFA)在左心室肥厚(LVH)、舒张功能参数和估算肾小球滤过率(eGFR)降低方面的临床应用价值。对 1028 名年龄在 40-64 岁、eGFR≥60 ml/min/1.73m2且接受常规健康检查的患者进行了横断面分析。根据 VFA 将患者分为三分位。评估了 VFA 与超声心动图参数和 eGFR 的相关性。在 VFA 三分位中,左心室质量指数(LVMi)、左心房直径(LAD)和早期二尖瓣血流速度与二尖瓣环速度峰值比(E/E' 比值)呈显著上升趋势,而早期至晚期二尖瓣血流峰值比(E/A 比值)和 eGFR 呈显著下降趋势。多元线性回归分析显示,对数值转换后的 VFA 与 LVMi、LAD 和 E/E' 比值的增加以及 E/A 比值和 eGFR 的降低显著相关。在校正体重指数后,对数值转换后的 VFA 仍然是 E/A 比值的重要决定因素。VFA 可能与中年肾功能正常或轻度受损患者的 LV 结构和舒张功能以及 eGFR 降低有关。