Hense H W, Gneiting B, Muscholl M, Broeckel U, Kuch B, Doering A, Riegger G A, Schunkert H
Institute of Epidemiology and Social Medicine, Clinical Epidemiology Unit, University Münster, Germany.
J Am Coll Cardiol. 1998 Aug;32(2):451-7. doi: 10.1016/s0735-1097(98)00240-x.
We investigated the relationship between body size, body composition and left ventricular mass (LVM) in adults, and assessed the impact of different indexations of LVM on its associations with gender, adiposity and blood pressure.
The best way to normalize LVM for body size to appropriately distinguish physiologic adaptation from morbid heart morphology was discussed.
We undertook a community survey of 653 men and 718 women, aged 25 to 74 years. Lean body mass (LBM) was determined by bioelectric impedance analyses and LVM was assessed by two-dimensional guided M-mode echocardiography.
After traditional indexations to body height, body height2.7, or body surface area, men had higher LVM than women (p < 0.001). These gender differences disappeared (p > 0.05) when LVM was indexed to LBM. The type of indexation also modified the strength of the association between adiposity and LVM. The estimated impact of body fat on LVM indexed to LBM was less than half that obtained with traditional indexations. In contrast, the magnitude of the associations of blood pressure with LVM was entirely independent of the type of indexation.
This study showed the prominent influence of body composition on adult heart size. Indexation for LBM removed gender differences for LVM and reduced the impact of adiposity, but left the effects of blood pressure unchanged. We suggest that this approach be used for clinical and research applications.
我们研究了成年人的体型、身体成分与左心室质量(LVM)之间的关系,并评估了不同的LVM指数化方法对其与性别、肥胖及血压之间关联的影响。
讨论了将LVM按体型进行标准化以恰当区分生理性适应与病态心脏形态的最佳方法。
我们对653名年龄在25至74岁之间的男性和718名年龄在25至74岁之间的女性进行了一项社区调查。通过生物电阻抗分析测定去脂体重(LBM),并通过二维引导M型超声心动图评估LVM。
在将LVM按身高、身高的2.7次方或体表面积进行传统指数化后,男性的LVM高于女性(p<0.001)。当将LVM按LBM进行指数化时,这些性别差异消失了(p>0.05)。指数化方法的类型也改变了肥胖与LVM之间关联的强度。按LBM指数化后,体脂对LVM的估计影响不到传统指数化方法所得到影响的一半。相比之下,血压与LVM之间关联的强度完全独立于指数化方法的类型。
本研究显示了身体成分对成人心脏大小的显著影响。按LBM进行指数化消除了LVM的性别差异,并降低了肥胖的影响,但血压的影响保持不变。我们建议将这种方法用于临床和研究应用。