老年超重人群左心房结构及左心室质量指数的影响因素分析  

Study on influencing factors of left atrial structure and left ventricular mass index in elderly overweight population

作　　者：沈伟 李毅[1] 葛余浩 张薇薇 罗梦琪 康冬梅 SHEN Wei;LI Yi;GE Yuhao;ZHANG Weiwei;LUO Mengqi;KANG Dongmei(Department of International Medical Affairs,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)国际医疗部,合肥230001

出　　处：《中国临床保健杂志》2024年第5期612-617,共6页Chinese Journal of Clinical Healthcare

基　　金：安徽省重点研究与开发计划人口健康专项(202004j07020012);中国科学院B类先导科技专项培育项目子课题(XDPB1004)。

摘　　要：目的探究老年超重人群左心房结构及左心室质量指数的影响因素。方法采用横断面研究,收集2019年1月至2021年7月在合肥某社区730名受试者信息,剔除149名因心脏彩色多普勒超声数据缺失的受试者后,根据体重指数(BMI)及年龄分段标准,最终纳入345名超重及正常体重的老年受试者,平均年龄67.76岁。其中超重组(23 kg/m^(2)≤BMI<27.5 kg/m^(2))194名,正常组(18.5 kg/m^(2)≤BMI<23 kg/m^(2))151名。心脏彩色多普勒超声参数包括左心房内径(LAD)、左心室质量指数(LVMI)等。记录2组受试者基本信息、实验室检查及超声心动图测量数据,并进行相关性分析。结果男性LAD高于女性[(37.20±4.68)mm比(35.43±3.77)mm,P<0.01],合并高血压人群的LAD及LVMI均高于不合并高血压人群[(37.67±3.81)mm比(35.37±3.70)mm,P<0.01;(47.48±7.98)g/m^(2)比(44.07±8.88)g/m^(2),P=0.001],超重人群的LAD及LVMI均高于正常BMI人群[(37.29±3.80)mm比(34.56±4.24)mm,P<0.01;(47.13±7.63)g/m^(2)比(43.10±9.61)g/m^(2),P<0.01]。相关性分析结果显示,LAD与年龄、腰臀比(WHR)、平均动脉压(MAP)、血红蛋白(HGB)、肌酐(Cr)、超敏C反应蛋白(hs-CRP)、胰岛素抵抗指数(HOMA-IR)呈正相关(P<0.05);LVMI与年龄、WHR、MAP呈正相关(P<0.05)。多元线性回归分析结果显示,年龄、BMI、WHR、MAP及hs-CRP是LAD的影响因素(均P<0.05);年龄、高血压、BMI、MAP是LVMI的影响因素(均P<0.05)。结论超重可引起心脏结构的改变。老年超重人群的左心房结构及左心室质量指数影响因素较多,应积极控制BMI、WHR、MAP,减少左心重构的发生。Objective To explore the influencing factors of left atrial structure and left ventricular mass index in elderly overweight population.Method A cross-sectional study was conducted to collect the information of 730 participants in a community in Hefei from January 2019 to July 2021.After excluding 149 participants with missing the data from the echocardiogram,345 overweight and normal weight elderly participants were finally included according to Body Mass Index(BMI)and age-segment criteria.The average age was 67.76 years.There were 194 patients in the overweight group(23 kg/m^(2)≤BMI<27.5 kg/m^(2))and 151 in the normal group(18.5 kg/m^(2)≤BMI<23 kg/m^(2)).Echocardiographic parameters include Left atrial diameter(LAD)and Left ventricular mass index(LVMI).Basic information,laboratory examination and echocardiographic measurement data of participants in the two groups were recorded,and correlation analysis was conducted.Results The LAD in males was higher than that in females[(37.20±4.68)mm vs(35.43±3.77)mm,P<0.01],and the LAD and LVMI in patients with hypertension were higher than those without hypertension[(37.67±3.81)mm vs(35.37±3.70)mm,P<0.01;(47.48±7.98)g/m^(2)vs(44.07±8.88)g/m^(2),P=0.001],LAD and LVMI in overweight population were higher than those in normal BMI population[(37.29±3.80)mm vs(34.56±4.24)mm,P<0.01;(47.13±7.63)g/m^(2)vs(43.10±9.61)g/m^(2),P<0.01].Correlation analysis showed that LAD was correlated with age,Waist-to-Hip Ratio(WHR),Mean arterial pressure,(MAP),hemoglobin content(HGB),creatinine(Cr),hypersensitive C-reactive protein(hs-CRP)and insulin resistance index(HOMA-IR)were positively correlated(P<0.05);LVMI was positively correlated with age,WHR and MAP(P<0.05).Multiple linear regression analysis showed that age,BMI grouping,WHR,MAP and hs-CRP were risk factors for LAD(P<0.05).Age,presence or absence of hypertension,BMI grouping and MAP were risk factors for LVMI(P<0.05).Conclusions Overweight can cause changes in heart structure.There are many factors affecting left atrial str

关 键 词：超重 心房重构 肥大 左心室 心脏病危险因素 老年人 

分 类 号：R589.2[医药卫生—内分泌]