高血压儿童青少年代谢异常指标聚集性与左心室肥厚的关系

Relationship between clustering of metabolic disorders and left ventricular hypertrophy in hypertensive children and adolescents

目的探讨儿童青少年代谢异常指标与左心室肥厚(LVH)之间的关系,为预防儿童青少年心脏结构损害提供参考依据。方法资料来源于2012年9月至2014年9月开展的国家"十二五"科技支撑计划课题项目"儿童心血管疾病的预警、诊治技术研究"分课题济南调查点,共纳入261名6~17岁高血压中小学生。采用协方差分析探讨代谢异常指标的聚集性对左心室质量指数(LVMI)水平的影响,采用多元Logistic回归模型探讨代谢异常指标聚集性对LVH的影响。结果调整性别、年龄和血压,携带0,1和≥2个代谢异常指标儿童青少年的平均LVMI分别为(33.21±1.85)(38.57±1.19)和(43.00±1.63)g/m^2.7;随着代谢异常指标数量的增加,LVMI水平逐渐增加(P<0.01)。与携带0个代谢异常指标的儿童青少年相比,携带1和≥2个代谢异常指标者罹患LVH的风险增加,OR值及95%CI分别为2.41(1.11~5.23)和4.69(2.05~10.74)。结论代谢异常指标聚集性增加儿童青少年的LVMI水平和罹患LVH的风险。需综合防控相关代谢异常指标,降低儿童青少年早期心脏结构的损害。

Objective To examine the relationship between clustering of metabolic disorders and left ventricular hypertrophy(LVH) in hypertensive children and adolescents, and to provide the reference for preventing the damage to their heart structure. Methods Based on the data from the Twelfth Five-year National Science and Technology Support Program "Early Warning, Diagnosis and Treatment of Cardiovascular Disease in Children" from September 2012 to September 2014 in Jinan, 261 children and adolescents aged 6-17 years whose hypertensive status was confirmed based on appearance of elevated blood pressure across three different occasions were included. Covariance analysis was used to analyze the relationship of clustering of metabolic disorders with left ventricular mass index levels. Multivariable logistic regression model was used to examine the relationship of clustering of metabolic disorders with LVH. Results After adjustment for sex, age and blood pressure, LVMI levels were(33.21±1.85)(38.57±1.19) and(43.00±1.63)g/m^2.7, respectively, for hypertensive children and adolescents carrying 0, 1 and ≥2 metabolic disorders;LVMI levels increased with the number of metabolic disorders in hypertensive children and adolescents(P<0.01). Compared with the hypertensive children and adolescents without any metabolic disorders, the risk for LVH increased in ones carrying 1 and ≥2 metabolic disorders, the odds ratios and 95% confidence intervals were 2.41(1.11-5.23) and 4.69(2.05-10.74), respectively. Conclusion The clustering of metabolic disorders was positively correlated with the LVMI levels and risk of LVH in hypertensive children and adolescents. Therefore, to prevent cardiac damage such as LVH in hypertensive children and adolescents, it is important to prevent and control metabolic disorders comprehensively.