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西班牙裔/拉丁裔人群的文化适应与心脏结构和功能的关系:拉丁裔超声心动图研究的横断面分析。

Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos.

机构信息

Department of Medicine/Hospital Medicine, San Francisco VA Medical Center, San Francisco, California, USA

Department of Medicine/Cardiology, Yeshiva University Albert Einstein College of Medicine, Bronx, New York, USA.

出版信息

BMJ Open. 2019 Nov 28;9(11):e028729. doi: 10.1136/bmjopen-2018-028729.

Abstract

OBJECTIVE

Hispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.

DESIGN

Cross-sectional.

SETTING

The Echocardiographic Study of Latinos.

PARTICIPANTS

1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.

PRIMARY AND SECONDARY OUTCOME MEASURES

Echocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.

RESULTS

The study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e' but lower LAVI and e' velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e' but lower e' velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e'.

CONCLUSIONS

Acculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.

摘要

目的

在美国,西班牙裔/拉丁裔是最大的移民群体,他们经历着文化适应的过程,并且面临着巨大的心衰风险负担。很少有研究探讨文化适应对心脏结构和功能的影响。

设计

横断面研究。

地点

拉丁裔超声心动图研究。

参与者

1818 名西班牙裔成年参与者,在基线时进行了超声心动图评估,并通过短版文化适应量表、出生地、移民年龄、在美国的居住时间、代际身份和语言来测量文化适应程度。

主要和次要结局测量

左心房容积指数(LAVI)、左心室质量指数(LVMI)、舒张早期经二尖瓣流入和二尖瓣环速度的超声心动图评估。

结果

研究人群主要为讲西班牙语和外国出生的人,在美国的平均居住时间为 22.7 年,平均年龄为 56.4 岁;50%患有高血压,28%患有糖尿病,44%的人体重指数(BMI)>30kg/m。多变量分析显示,随着在美国居住年限的增加,LAVI 越高。与第二代相比,第一代和第一代移民的 E/e'更高,但 LAVI 和 e'速度更低。较高的文化适应程度和收入>$20K 与较高的 LVMI、LAVI 和 E/e'相关,但与较低的 e'速度相关。收入<$20K 的偏好西班牙语的人 E/e'更高。

结论

文化适应与心脏结构和功能异常有关,社会经济地位存在一定的调节作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0be8/6924788/0cc390b2bd91/bmjopen-2018-028729f01.jpg

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