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中国儿童心血管危险因素聚集与左心室几何重构之间的关联

Association between clustering of cardiovascular risk factors and left ventricular geometric remodeling in Chinese children.

作者信息

Liu Qin, Wang Huan, Zhao Min, Zhang Cheng, Bovet Pascal, Xi Bo

机构信息

Department of Ultrasound, Children's Hospital of the Capital Institute of Pediatrics, Beijing, China.

Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.

出版信息

Front Cardiovasc Med. 2023 Aug 17;10:1236730. doi: 10.3389/fcvm.2023.1236730. eCollection 2023.

Abstract

BACKGROUND

Several cardiovascular (CV) risk factors are reported to be associated with abnormal cardiac structure in children and adults. However, no study has assessed the association between clustering of multiple CV risk factors and left ventricular geometric (LVG) remodeling. We examined the association between clustering of CV risk factors and LVG remodeling among Chinese children.

METHODS

This cross-sectional study included 1,406 children aged 6-11 years. Clustering of CV risk factors was quantified as the sum of the number of five CV risk factors (abdominal obesity, elevated blood pressure, high fasting blood glucose, high triglycerides and low high-density lipoprotein cholesterol). Based on left ventricular mass index and relative wall thickness (RWT), left ventricular hypertrophy (LVH), high RWT and LVG remodeling [concentric remodeling (CR), eccentric hypertrophy (EH) and concentric hypertrophy (CH)] were defined.

RESULTS

Compared to participants without CV risk factor, those with 1, 2 and ≥3 risk factors were at increased risk of LVH [ORs (95% CIs): 3.49 (2.19-5.56), 5.53 (3.20-9.55), and 19.19 (9.67-38.08), respectively]; corresponding values for high RWT were 2.47 (1.63-3.74), 3.76 (2.25-6.27), and 5.47 (2.65-11.28). Similar associations between clustering of CV risk factors and LVG remodeling were found [CR: 1.71 (1.06-2.76), 2.83 (1.54-5.18), and 3.82 (1.37-10.62); EH: 2.42 (1.42-4.11), 4.23 (2.24-7.96), and 16.86 (7.70-36.92); CH: 14.92 (4.41-50.47), 23.15 (6.32-84.83), and 71.19 (17.09-296.56)].

CONCLUSION

CV risk factors in isolation and combination were associated with an increased risk of LVH, high RWT and LVG remodeling among children, emphasizing the need to consider multiple risk factors when assessing the risk of cardiac outcomes.

摘要

背景

据报道,几种心血管(CV)危险因素与儿童和成人的心脏结构异常有关。然而,尚无研究评估多种CV危险因素聚集与左心室几何(LVG)重塑之间的关联。我们研究了中国儿童CV危险因素聚集与LVG重塑之间的关联。

方法

这项横断面研究纳入了1406名6至11岁的儿童。CV危险因素聚集被量化为五种CV危险因素(腹型肥胖、血压升高、空腹血糖升高、高甘油三酯和低高密度脂蛋白胆固醇)数量的总和。根据左心室质量指数和相对壁厚度(RWT),定义了左心室肥厚(LVH)、高RWT和LVG重塑[向心性重塑(CR)、离心性肥厚(EH)和向心性肥厚(CH)]。

结果

与无CV危险因素的参与者相比,有1个、2个和≥3个危险因素的参与者发生LVH的风险增加[比值比(95%可信区间):分别为3.49(2.19 - 5.56)、5.53(3.20 - 9.55)和19.19(9.67 - 38.08)];高RWT的相应值分别为2.47(1.63 - 3.74)、3.76(2.25 - 6.27)和5.47(2.65 - 11.28)。在CV危险因素聚集与LVG重塑之间发现了类似的关联[CR:1.71(1.06 - 2.76)、2.83(1.54 - 5.18)和3.82(1.37 - 10.62);EH:2.42(1.42 - 4.11)、4.23(2.24 - 7.96)和16.86(7.70 - 36.92);CH:14.92(4.41 - 50.47)、23.15(6.32 - 84.83)和71.19(17.09 - 296.56)]。

结论

单独和综合的CV危险因素均与儿童LVH、高RWT和LVG重塑风险增加有关,强调在评估心脏结局风险时需要考虑多种危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83b1/10469610/f15269355f8b/fcvm-10-1236730-g001.jpg

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