From the Department of Non-Communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China (Y.Y., J.M.).
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA (Y.Y., Y.G., C.F., L.B., J.H., W.C.).
Circ Res. 2020 Feb 28;126(5):633-643. doi: 10.1161/CIRCRESAHA.119.316045. Epub 2020 Jan 29.
Data are limited regarding the influence of life-course cumulative burden of increased body mass index (BMI) and elevated blood pressure (BP) on the progression of left ventricular (LV) geometric remodeling in midlife.
To investigate the dynamic changes in LV mass and LV geometry over 6.4 years during midlife and to examine whether the adverse progression of LV geometric remodeling is influenced by the cumulative burden of BMI and BP from childhood to adulthood.
The study consisted of 877 adults (604 whites and 273 blacks; 355 males; mean age=41.4 years at follow-up) who had 5 to 15 examinations of BMI and BP from childhood and 2 examinations of LV dimensions at baseline and follow-up 6.4 years apart during adulthood. The area under the curve (AUC) was calculated as a measure of long-term burden (total AUC) and trends (incremental AUC) of BMI and systolic BP (SBP). After adjusting for age, race, sex, smoking, alcohol drinking, and baseline LV mass index, the annual increase rate of LV mass index was associated with all BMI measures (β=0.16-0.36, <0.05 for all), adult SBP (β=0.07, =0.04), and total AUC of SBP (β=0.09, =0.01) but not with childhood and incremental AUC values of SBP. All BMI and SBP measures (except childhood SBP) were significantly associated with increased risk of incident LV hypertrophy, with odds ratios of BMI (odds ratio=1.85-2.74, <0.05 for all) being significantly greater than those of SBP (odds ratio=1.09-1.34, <0.05 for all except childhood SBP). In addition, all BMI measures were significantly and positively associated with incident eccentric and concentric LV hypertrophy.
Life-course cumulative burden of BMI and BP is associated with the development of LV hypertrophy in midlife, with BMI showing stronger associations than BP. Visual Overview: An online visual overview is available for this article.
关于一生中体重指数（BMI）和血压（BP）升高的累积负担对中年人心室重构进展的影响，数据有限。
研究中年时左心室（LV）质量和 LV 几何结构 6.4 年内的动态变化，并探讨 BMI 和 BP 从儿童到成年的累积负担是否影响 LV 几何重构的不良进展。
本研究纳入了 877 名成年人（604 名白人和 273 名黑人；355 名男性；随访时平均年龄为 41.4 岁），他们在儿童期进行了 5 至 15 次 BMI 和 BP 检查，并在成年期进行了基线和随访 6.4 年的 2 次 LV 测量。曲线下面积（AUC）被计算为衡量长期负担（总 AUC）和 BMI 和收缩压（SBP）的趋势（递增 AUC）的指标。在校正年龄、种族、性别、吸烟、饮酒和基线 LV 质量指数后，LV 质量指数的年增长率与所有 BMI 指标（β=0.16-0.36，均<0.05）、成人 SBP（β=0.07，=0.04）和 SBP 的总 AUC（β=0.09，=0.01）相关，但与儿童和 SBP 的递增 AUC 值无关。所有 BMI 和 SBP 指标（儿童 SBP 除外）与发生 LV 肥厚的风险增加显著相关，BMI 的比值比（比值比=1.85-2.74，均<0.05）明显大于 SBP（比值比=1.09-1.34，除儿童 SBP 外，均<0.05）。此外，所有 BMI 指标均与发生偏心和同心 LV 肥厚显著正相关。
一生中 BMI 和 BP 的累积负担与中年时 LV 肥厚的发展有关，BMI 的相关性强于 BP。
本文提供了在线直观概述。
