Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Cardiol. 2022 Jul;45(7):767-777. doi: 10.1002/clc.23838. Epub 2022 May 3.
We investigated the association between individual components of metabolic syndrome (MetS) and left ventricular (LV) geometric changes, including diastolic dysfunction, in a large cohort of healthy individuals.
Overall, 148 461 adults who underwent echocardiography during a health-screening program were enrolled. Geographic characteristics on echocardiography and several markers of LV relaxation function were identified according to individual MetS components. Univariate linear regression analysis and a multivariate regression model adjusted for factors known to influence LV relaxation function were conducted.
The prevalence of LV diastolic dysfunction (LVDD) was higher in the MetS group than in the non-MetS group (0.56% vs. 0.27%, p < .001). In univariate and multivariate analyses, E/A ratio, e' velocity, and left atrial volume index were significantly associated with each component of MetS and covariates (all p ≤ .001). In the age- and sex-adjusted model, MetS was significantly associated with LVDD (odds ratio [95% confidence interval], 1.350 [1.103, 1.652]). However, subjects with more MetS components did not have a significantly higher risk of LVDD. As the analysis was stratified by sex, the multivariate regression model showed that MetS was significantly associated with LVDD only in men (1.3 [1.00, 1.68]) with higher risk in more MetS component (p for trend < .001). In particular, triglyceride (TG) and waist circumference (WC) among MetS components were significantly associated with LVDD in men.
MetS was associated with the risk of LVDD, especially in men, with a dose-dependent association between an increasing number of components of MetS and LVDD. TG and WC were independent risk factors for LVDD in men.
我们在一个大型健康人群队列中研究了代谢综合征（MetS）的各个组成部分与左心室（LV）几何变化之间的关系，包括舒张功能障碍。
共纳入了 148461 名在健康筛查计划中接受超声心动图检查的成年人。根据个体 MetS 成分确定了超声心动图的地理特征和几个 LV 松弛功能标志物。进行了单变量线性回归分析和多变量回归模型，模型调整了已知影响 LV 松弛功能的因素。
与非 MetS 组相比，MetS 组的 LV 舒张功能障碍（LVDD）患病率更高（0.56%比 0.27%，p<0.001）。在单变量和多变量分析中，E/A 比值、e'速度和左心房容积指数与 MetS 的各个成分和协变量均显著相关（均 p≤0.001）。在年龄和性别调整模型中，MetS 与 LVDD 显著相关（比值比[95%置信区间]，1.350[1.103，1.652]）。然而，具有更多 MetS 成分的受试者患 LVDD 的风险并未显著增加。在按性别分层的分析中，多变量回归模型显示，MetS 仅与男性的 LVDD 显著相关（1.3[1.00，1.68]），且具有更多 MetS 成分的风险更高（趋势 p<0.001）。特别是 MetS 成分中的甘油三酯（TG）和腰围（WC）与男性的 LVDD 显著相关。
MetS 与 LVDD 的风险相关，尤其是在男性中，MetS 成分的数量与 LVDD 之间呈剂量依赖性关联。TG 和 WC 是男性 LVDD 的独立危险因素。
