高三酸甘油酯血症與左心室肥大之相關性研究

The Relationship Between Hypertriglyceridemia and Left Ventricular Hypertrophy

目的：左心室肥大(left ventricular hypertrophy, LVH)為一重要心血管風險因子，當前研究主要聚焦在低密度脂蛋白膽固醇(low-density lipoprotein cholesterol, LDL-C)，針對與三酸甘油酯(triglyceride, TG)間的關聯討論較少且結果不一致，本篇則旨在探討高三酸甘油酯血症與LVH間關係。

方法：此回顧性研究蒐集自2008年6月至2018年5月間，至北台灣一醫學中心健康檢查的民眾做為參與者。我們根據參與者的空腹血中三酸甘油酯數值將之分為三組：低於150 mg/dL、介於150-199 mg/dL間，以及大於等於200 mg/dL。透過心臟超音波檢查結果，我們定義LVH為女性左心室質量指數超過95 g/m2者，男性為超過115 g/m2者。我們利用多元邏輯迴歸分析觀察TG濃度與LVH之間的關聯，並進行次群組分析以檢驗此關聯在不同年齡和性別群體中是否存在差異。

結果：本篇研究共包含3,830名參加者，平均年齡為52.9歲。各TG濃度組的LVH比例分別為3.5%，5.0%和6.8% (test for trend, p< 0.05)。調整潛在干擾因子後，TG濃度高於200 mg/dL族群的LVH風險較高 [adjusted odds ratio (aOR), 1.57; 95% confidence interval (CI), 1.04-2.37]。次群組分析顯示在不同年齡和性別的分層趨勢皆與主要結果一致。

結論：升高的空腹血中TG濃度(≥200 mg/dL)顯著增加LVH的風險。控制高三酸甘油酯血症對降低心血管風險至關重要。

 

Background: Left ventricular hypertrophy (LVH), a significant cardiovascular risk, has been associated with lipid profiles, mainly focusing on low-density lipoprotein cholesterol (LDL-C). However, literature on the association between triglycerides (TG) and the risk of LVH is limited and inconsistent. This study investigates the relationship between hypertriglyceridemia and LVH.

Methods: This retrospective study recruited participants from a health center between June 2008 and May 2018, and their information was obtained from hospital records. We divided participants into three groups according to their fasting triglyceride (TG) levels: TG level below 150 mg/dL, between 150-199 mg/dL, and greater or equal to 200 mg/dL. LVH was defined as a left ventricular mass index over 95 g/m2 in women and 115 g/m2 in men, determined by echocardiography. Logistic regression was used to investigate the association between TG levels and LVH. Subgroup analyses were performed to examine whether the association between TG levels and LVH varied by different age and sex groups.

Results: The study included 3,830 participants with a mean age of 52.9 years. The proportion of LVH in the different groups of TG levels was 3.5%, 5.0%, and 6.8%, respectively (test for trend, p< 0.05). Participants with TG levels greater or equal to 200 mg/dL were associated with a higher risk of LVH after adjusting for potential confounding factors [adjusted odds ratio (aOR) 1.57, 95 % confidence interval (CI) 1.04-2.37]. Subgroup analyses revealed consistent results with the main results across different age and sex strata.

Conclusion: Elevated fasting TG levels (≥200 mg/dL) significantly increase LVH risk. Controlling hypertriglyceridemia is vital for reducing cardiovascular risk.