Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.
Int J Cardiol. 2018 Mar 15;255:118-123. doi: 10.1016/j.ijcard.2017.07.089.
The association between low skeletal muscle mass and left ventricular diastolic dysfunction (LVDD), a predictor of future heart failure, is largely unexplored. We investigated the relationship between relative muscle mass and LVDD.
We conducted a cross-sectional study in 67,106 Koreans who underwent an echocardiography as part of a comprehensive health examination between January 2012 and December 2014. Skeletal muscle mass index (SMI) [SMI (%)=total skeletal muscle mass (kg)/body weight (kg)×100] was estimated using a bioelectrical impedance analyzer. The presence of LVDD was determined using echocardiographic findings.
In 67,106 participants, 19,232 subjects (28.7%) and 1553 subjects (2.3%) had LVDD and left ventricular (LV) hypertrophy, respectively. SMI was positively associated with E/A ratio and septal E', whereas E/E' ratio and LV mass index were negatively associated with SMI. Lower SMI was associated with increased presence of LVDD. In a multivariable-adjusted model controlling for potential confounders including physical activity, insulin resistance, and LV mass, the odds ratios for LVDD in SMI quartiles 1, 2, and 3 compared with quartile 4 were 2.11 (1.97-2.25), 1.79 (1.68-1.90), and 1.45 (1.36-1.55), respectively (P for trend<0.001).
In a large sample of young and middle-aged Korean adults, low relative muscle mass was independently associated with increased risk of LVDD, indicating an independent role of skeletal muscle mass in the pathogenesis of LVDD.
低骨骼肌量与左心室舒张功能障碍（LVDD）密切相关，后者是心力衰竭的预测因子，但两者之间的关系尚未完全阐明。本研究旨在探讨相对肌肉量与 LVDD 之间的关系。
我们对 2012 年 1 月至 2014 年 12 月期间接受全面健康检查并接受超声心动图检查的 67106 名韩国人进行了横断面研究。采用生物电阻抗分析仪估算骨骼肌质量指数（SMI）[SMI（%）=骨骼肌总量（kg）/体重（kg）×100]。通过超声心动图检查结果确定 LVDD 的存在。
在 67106 名参与者中，19232 名（28.7%）和 1553 名（2.3%）受试者存在 LVDD 和左心室肥厚。SMI 与 E/A 比值和室间隔 E'呈正相关，而 E/E'比值和 LV 质量指数与 SMI 呈负相关。较低的 SMI 与 LVDD 的发生率增加相关。在调整了包括体力活动、胰岛素抵抗和 LV 质量在内的潜在混杂因素的多变量校正模型中，SMI 四分位数 1、2 和 3 与四分位数 4 相比，LVDD 的比值比分别为 2.11（1.97-2.25）、1.79（1.68-1.90）和 1.45（1.36-1.55）（P<0.001）。
在一个大型的年轻和中年韩国成年人样本中，相对较低的肌肉量与 LVDD 风险增加独立相关，表明骨骼肌质量在 LVDD 发病机制中具有独立作用。
