Daniels S R, Kimball T R, Morrison J A, Khoury P, Meyer R A
Department of Pediatrics, University of Cincinnati College of Medicine, Ohio, USA.
Am J Cardiol. 1995 Oct 1;76(10):699-701. doi: 10.1016/s0002-9149(99)80200-8.
Left ventricular (LV) mass has been established as an independent risk factor for cardiovascular disease morbidity and mortality. To account for differences in body size, a variety of factors have been proposed for indexing LV mass. Dual energy x-ray absorptiometry provides a measure of lean body mass which can be used as a comparison with other more clinically applicable methods of standardization. The study included 192 subjects (100 male, 103 white) aged 6 to 17 years. Lean body mass was determined by dual energy x-ray absorptiometry and LV mass was calculated from M-mode echocardiographic measurements. There were significant differences by gender (males 98.7 g, females 80.3g, p < 0.001), but not race, for unindexed LV mass. Indexing LV mass by lean body mass eliminated the difference by gender. Log-log regression analysis revealed that the optimal height exponent for indexing LV mass was height3 (95% confidence interval, 2.8 to 3.1). LV mass/height3 provided the most consistently high intraclass correlation with LV mass/lean body mass versus indexing with body surface area, height, height2, and height2.7 across the 4 race/gender groups. LV mass indexed by height3 eliminated differences in LV mass by gender (males 26.1 +/- 4.72 g/m3, females 25.5 +/- 4.8 g/m3, p = NS). The proposed method for indexing LV mass by height3 should be useful in the clinical setting. The 90th and 95th percentiles of LV mass/height3 provide cutpoints for determining the presence of LV hypertrophy in children and adolescents.
左心室（LV）质量已被确认为心血管疾病发病和死亡的独立危险因素。为了考虑体型差异，人们提出了多种用于左心室质量指数化的因素。双能X线吸收法可测量瘦体重，可用于与其他更具临床适用性的标准化方法进行比较。该研究纳入了192名年龄在6至17岁的受试者（100名男性，103名白人）。通过双能X线吸收法测定瘦体重，并根据M型超声心动图测量计算左心室质量。未指数化的左心室质量在性别上存在显著差异（男性98.7克，女性80.3克，p<0.001），但在种族上无差异。用瘦体重对左心室质量进行指数化消除了性别差异。对数-对数回归分析显示，左心室质量指数化的最佳身高指数为身高³（95%置信区间，2.8至3.1）。在4个种族/性别组中，左心室质量/身高³与左心室质量/瘦体重的组内相关性始终高于与体表面积、身高、身高²和身高².7指数化的相关性。用身高³指数化的左心室质量消除了性别差异（男性26.1±4.72克/立方米，女性25.5±4.8克/立方米，p=无显著性差异）。所提出的用身高³对左心室质量进行指数化的方法在临床环境中应是有用的。左心室质量/身高³的第90和第95百分位数为确定儿童和青少年左心室肥厚的存在提供了切点。
