超重和肥胖会损害左心室收缩功能，通过左心室射血分数和整体纵向应变来衡量。
Overweight and obesity impair left ventricular systolic function as measured by left ventricular ejection fraction and global longitudinal strain.
机构信息
Department of Clinical Physiology, County Hospital Ryhov, Jönköping, Sweden.
Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
出版信息
Cardiovasc Diabetol. 2018 Aug 14;17(1):113. doi: 10.1186/s12933-018-0756-2.
AIMS
Obesity is associated with type 2 diabetes mellitus, left ventricular diastolic dysfunction and heart failure but it is unclear to which extent it is related to left ventricular systolic dysfunction. The aim of the study was to explore the effects of overweight and obesity on left ventricular systolic function in patients with type 2 diabetes mellitus and a control group of non-diabetic persons.
METHODS
We prospectively investigated 384 patients with type 2 diabetes mellitus, and 184 controls who participated in the CARDIPP and CAREFUL studies. The participants were grouped according to body mass index (normal weight < 25 kg/m, overweight 25-29 kg/m, and obesity ≥ 30 kg/m). Echocardiography was performed at the beginning of the study and after 4-years in the patient group.
RESULTS
Univariable and multivariable regression analysis revealed that variations in left ventricular ejection fraction, global longitudinal strain, left ventricular mass and diastolic function expressed as E/é (the ratio between early diastolic mitral flow and annular motion velocities) all are related to body mass index. The mean and standard deviation of left ventricular ejection fraction and global longitudinal strain values were 57% (8%) vs. - 18.6% (2.3%) for normal weight patients, 53% (8%) vs. - 17.5% (2.3%) for overweight, and 49% (9%) vs. - 16.2% (3.0%) for obese (p < 0.05 vs. p < 0.05). Corresponding results in the control group were 58% (6%) vs. - 22.3% (3.0%), 55% (7%) vs. - 20.8% (3.1%) and 54% (8%) - 19.6% (4.0%) (p < 0.05 vs. p < 0.05). Patients who gained weight from baseline to follow-up changed left ventricular ejection fraction (median and interquartile range) by - 1.0 (9.0) % (n = 187) and patients who lost weight changed left ventricular ejection fraction by 1.0 (10.0) % (n = 179) (p < 0.05).
CONCLUSION
Overweight and obesity impair left ventricular ejection fraction and global longitudinal strain in both patients with type 2 diabetes mellitus and non-diabetic persons. Trial registration ClinicalTrials.gov identifier NCT 01049737.
目的
肥胖与 2 型糖尿病、左心室舒张功能障碍和心力衰竭有关，但肥胖与左心室收缩功能障碍的关系尚不清楚。本研究旨在探讨超重和肥胖对 2 型糖尿病患者及非糖尿病对照组患者左心室收缩功能的影响。
方法
我们前瞻性调查了 384 例 2 型糖尿病患者和 184 例非糖尿病对照组患者，这些患者参加了 CARDIPP 和 CAREFUL 研究。根据体重指数（正常体重<25kg/m²、超重 25-29kg/m²和肥胖≥30kg/m²）将参与者分组。在研究开始时和患者组 4 年后进行超声心动图检查。
结果
单变量和多变量回归分析显示，左心室射血分数、整体纵向应变、左心室质量和舒张功能（以 E/é 表示，即二尖瓣早期舒张血流与环向运动速度之比）的变化均与体重指数相关。正常体重患者的左心室射血分数和整体纵向应变的平均值和标准差分别为 57%（8%）和-18.6%（2.3%），超重患者分别为 53%（8%）和-17.5%（2.3%），肥胖患者分别为 49%（9%）和-16.2%（3.0%）（p<0.05 与 p<0.05）。对照组的相应结果分别为 58%（6%）和-22.3%（3.0%）、55%（7%）和-20.8%（3.1%）和 54%（8%）和-19.6%（4.0%）（p<0.05 与 p<0.05）。从基线到随访体重增加的患者左心室射血分数（中位数和四分位距）变化为-1.0（9.0）%（n=187），而体重减轻的患者左心室射血分数变化为 1.0（10.0）%（n=179）（p<0.05）。
结论
超重和肥胖会损害 2 型糖尿病患者和非糖尿病患者的左心室射血分数和整体纵向应变。临床试验注册号 NCT 01049737。
Zotero 插件