将异常脂肪分布与 HFpEF 和舒张功能障碍联系起来：观察性研究的系统评价、荟萃分析和荟萃回归。
Linking abnormal fat distribution with HFpEF and diastolic dysfunction: a systematic review, meta-analysis, and meta-regression of observational studies.
机构信息
Department of General Internal Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
出版信息
Lipids Health Dis. 2024 Aug 31;23(1):277. doi: 10.1186/s12944-024-02266-y.
BACKGROUND
The global prevalence of obesity has escalated into a formidable health challenge intricately linked with the risk of developing cardiac diastolic disfunction and heart failure with preserved ejection fraction (HFpEF). Abnormal fat distribution is potentially strongly associated with an increased risk of cardiac diastolic dysfunction, and we aimed to scrutinize and elucidate the correlation between them.
METHODS
Following the Cochrane Handbook and PRISMA 2020 guidelines, we systematically reviewed the literature from PubMed, Embase, and Web of Science. We focused on studies reporting the mean and standard deviation (SD) of abnormal fat in HFpEF or cardiac diastolic dysfunction patients and the Pearson/Spearman correlation coefficients for the relationship between abnormal fat distribution and the risk of developing cardiac diastolic dysfunction. Data were standardized to the standard mean difference (SMD) and Fisher's z value for meta-analysis.
RESULTS
After progressive filtering and selection, 63 studies (43,113 participants) were included in the quantitative analyses. Abnormal fat distribution was significantly greater in participants with cardiac diastolic dysfunction than in controls [SMD 0.88 (0.69, 1.08)], especially in epicardial adipose tissue [SMD 0.99 (0.73, 1.25)]. Abnormal fat distribution was significantly correlated with the risk of developing cardiac diastolic dysfunction [E/E': 0.23 (0.18, 0.27), global longitudinal strain: r=-0.11 (-0.24, 0.02)]. Meta-regression revealed sample size as a potential heterogeneous source, and subgroup analyses revealed a stronger association between abnormal fat distribution and the risk of developing cardiac diastolic dysfunction in the overweight and obese population.
CONCLUSION
Abnormal fat distribution was significantly associated with the risk of developing cardiac diastolic dysfunction.
TRIAL REGISTRATION
CRD42024543774.
背景
肥胖在全球的流行率不断上升，成为一个严峻的健康挑战，与心脏舒张功能障碍和射血分数保留型心力衰竭（HFpEF）的发病风险密切相关。异常脂肪分布可能与心脏舒张功能障碍的风险增加密切相关，我们旨在仔细研究并阐明两者之间的相关性。
方法
根据 Cochrane 手册和 PRISMA 2020 指南，我们系统地检索了 PubMed、Embase 和 Web of Science 中的文献。我们专注于报告 HFpEF 或心脏舒张功能障碍患者异常脂肪的平均值和标准差（SD）以及异常脂肪分布与心脏舒张功能障碍发病风险之间关系的 Pearson/Spearman 相关系数的研究。数据标准化为标准均数差（SMD）和 Fisher z 值进行荟萃分析。
结果
经过逐步筛选和选择，63 项研究（43113 名参与者）纳入定量分析。心脏舒张功能障碍患者的异常脂肪分布明显大于对照组[SMD 0.88（0.69，1.08）]，尤其是心外膜脂肪组织[SMD 0.99（0.73，1.25）]。异常脂肪分布与心脏舒张功能障碍的发病风险显著相关[E/E'：0.23（0.18，0.27），整体纵向应变：r=-0.11（-0.24，0.02）]。元回归显示样本量是一个潜在的异质性来源，亚组分析显示，在超重和肥胖人群中，异常脂肪分布与心脏舒张功能障碍的发病风险之间的相关性更强。
结论
异常脂肪分布与心脏舒张功能障碍的发病风险显著相关。
试验注册
CRD42024543774。
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