Zhang Xueyao, Li Guangxiao, Zhang Dongyuan, Sun Yingxian
Department of Cardiology, First Hospital of China Medical University, Shenyang, China.
Department of Medical Record Management, First Hospital of China Medical University, Shenyang, China.
J Clin Hypertens (Greenwich). 2024 Dec;26(12):1342-1350. doi: 10.1111/jch.14716. Epub 2023 Oct 4.
Although hypertension and obesity are both risk factors for left ventricular hypertrophy (LVH), the extent of their impact on LVH in the general population is still unclear, and the predictive value of obesity indicators for LVH remains to be elucidated. In this study, obesity-related indicators, including waist circumference (WC), waist-height ratio (WHTR), and waist-hip ratio (WHR), were used to define abdominal obesity (AO), whereas body mass index (BMI) was used to measure general obesity (GO). The effects of hypertension and obesity on LVH were estimated using logistic regression analysis, as was the relative risk of LVH based on the presence of obesity, hypertension, or both. Subgroup analyses were performed based on sex and age. Of the 9134 participants (≥35 years old), 915 (10.0%) developed LVH. After adjusting for covariates, the odds ratios (95% confidence intervals) for LVH were 3.94 (3.27-4.75) in patients with hypertension, 1.90 (1.60-2.26) in those with GO, and 1.45 (1.25-1.69), 1.69 (1.43-2.00), and 1.54 (1.33-4.75) in individuals with AO defined based on WC, WHTR, and WHR, respectively. Analysis by sex showed similar values in women, but AO based on WC and WHR were not significantly associated with LVH in men. Further, after adjusting for potential confounding factors, concomitant hypertension and obesity had an increased risk of developing LVH in all age ranges, particularly in patients aged 35-45 years (risk increased 14.14-fold, 10.84-fold, 7.97-fold, and 9.95-fold for BMI-based GO and WC-, WHTR-, and WHR-based AO, respectively), and in both men and women but particularly in men (risk increased 7.71-fold, 4.67-fold, 5.83-fold, and 5.58-fold, respectively). In summary, all obesity indicators (BMI, WC, WHTR, and WHR) had predictive value for LVH in women; however, only BMI and WHTR should be considered for men. Furthermore, monitoring for the occurrence and progression of LVH is imperative for rural Chinese patients with concomitant hypertension and obesity, especially men and those aged 35-45 years.
尽管高血压和肥胖都是左心室肥厚(LVH)的危险因素,但它们对普通人群LVH的影响程度仍不明确,肥胖指标对LVH的预测价值仍有待阐明。在本研究中,使用包括腰围(WC)、腰高比(WHTR)和腰臀比(WHR)在内的肥胖相关指标来定义腹型肥胖(AO),而使用体重指数(BMI)来衡量全身肥胖(GO)。使用逻辑回归分析评估高血压和肥胖对LVH的影响,以及基于肥胖、高血压或两者并存情况下LVH的相对风险。根据性别和年龄进行亚组分析。在9134名年龄≥35岁的参与者中,915人(10.0%)发生了LVH。在调整协变量后,高血压患者发生LVH的比值比(95%置信区间)为3.94(3.27 - 4.75),GO患者为1.90(1.60 - 2.26),基于WC、WHTR和WHR定义的AO个体分别为1.45(1.25 - 1.69)、1.69(1.43 - 2.00)和1.54(1.33 - 4.75)。按性别分析显示,女性的数值相似,但基于WC和WHR的AO在男性中与LVH无显著关联。此外,在调整潜在混杂因素后,高血压和肥胖并存会增加各年龄段发生LVH的风险,尤其是35 - 45岁的患者(基于BMI的GO以及基于WC、WHTR和WHR的AO发生LVH的风险分别增加14.14倍、10.84倍、7.97倍和9.95倍),且在男性和女性中均如此,但在男性中尤为明显(风险分别增加7.71倍、4.67倍、5.83倍和5.58倍)。总之,所有肥胖指标(BMI、WC、WHTR和WHR)对女性LVH均有预测价值;然而,男性仅应考虑BMI和WHTR。此外,对于中国农村地区高血压和肥胖并存的患者,尤其是男性和35 - 45岁的患者,监测LVH的发生和进展势在必行。