左心室亚临床心功能异常对腹型肥胖患者发生代谢综合征的预测价值  

Predictive value of subclinical left ventricular dysfunction for metabolic syndrome in patients with abdominal obesity

作　　者：王婷 安彩云[1] WANG Ting;AN Caiyun(Department of Ultrasound,Yan an People′s Hospital,Yan an 716000,China)

机构地区：[1]延安市人民医院超声诊断科,陕西延安716000

出　　处：《延安大学学报（医学科学版）》2021年第4期53-57,共5页Journal of Yan'an University:Medical Science Edition

摘　　要：目的探讨左心室亚临床心功能异常预测腹型肥胖(abdominal obesity,AO)患者发展为代谢综合征(metabolic syndrome,MetS)的临床价值。方法连续选取延安市人民医院体检中心AO患者215例,收集人体测量学数据、生化数据以及超声心动图数据,进行3年随访。随访过程中发生MetS记入MetS组,未发生MetS的受试者记入non-MetS组。随访结束后,比较2组基线资料,并进行ROC曲线和COX回归分析,筛选AO患者发展为MetS的预测因素。结果 ROC分析显示,采用LAVI≥19.9 mL/m^(2)为截点值,预测MetS的ROC曲线面积0.697(0.631~0.758,P<0.001),灵敏度65.5%,特异度68.2%;采用E/e′≥9.6为截点值,预测MetS的ROC曲线面积0.868(0.815~0.910,P<0.001),灵敏度84.5%,特异度75.2%;采用GLS≤17.2%为截点值,预测MetS的ROC曲线面积0.813(0.755~0.863,P<0.001),灵敏度69.0%,特异度80.9%。COX回归分析显示,矫正年龄、性别、体重指数、LAVI、WHR以及代谢综合征家族史,E/e′≥9.6(HR=6.341,P<0.001)和GLS≤17.2%(HR=2.518,P<0.001)是预测AO发展为MetS的独立预测因子。结论左心室亚临床心功能异常是AO患者发展为MetS的早期标志,对腹型肥胖发展为代谢综合征具有一定的预测价值。Objective To investigate the clinical value of subclinical left ventricular dysfunction in predicting the development of metabolic syndrome(MetS) from abdominal obesity(AO).Methods 215 AO in Physical Examination Center of Yan’an People′s Hospital were selected.Routine anthropometric data,biochemical data and echocardiography data were collected and followed up for 3 years.During the follow-up,patients with MetS were assigned to MetS group,and subjects without MetS were assigned to non-MetS group.After the follow-up,the baseline data of the two groups were compared,and the ROC curve and Cox regression analysis were performed to screen the predictive factors for the development of MetS in patients with AO.Results The area of ROC curve of LAVI(cut off:LAVI≥19.9 mL/m^(2)) for predicting MetS was 0.697(0.631~0.758,P<0.001),and the sensitivity and specificity were 65.5% and 68.2%,respectively.The area of ROC curve of E/e′(cut off:E/e′≥9.6) for predicting MetS was 0.868(0.815~0.910,P<0.001),and the sensitivity and specificity were 84.5% and 75.2%,respectively.The area of ROC curve of GLS(cut off:GLS≤17.2%) for predicting MetS was 0.813(0.755~0.863,P<0.001),and the sensitivity and specificity were 69.0% and 80.9%,respectively.Cox regression analysis showed that adjusted age,gender,body mass index,LAVI,WHR,and family history of metabolic syndrome,E/e′≥9.6(HR = 6.341,P<0.001) and GLS≤17.2%(HR = 2.518,P<0.001) were independent predictors for the development of MetS from AO.Conclusion Subclinical left ventricular dysfunction may be an early marker for the development of MetS in patients with AO,and it has a predictive value for AO to develop into metabolic syndrome.

关 键 词：亚临床心功能异常 左心室 腹型肥胖 代谢综合征 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学]