Correlation Between Metabolic Risk Factors And Left Ventricular Diastolic Dysfunction In Tibet And Xinjiang

ObjectiveTo investigate the correlation between metabolic risk factors and left ventricular diastolic dysfunction(LVDD)in Tibetan and Xinjiang population of China.MethodsThe research subjects were from the Study on Prevalence of Chronic Cardiopulmonary Disease in Tibet and Xinjiang Area supported by the Chinese National Special Fund for Health-Scientific Research in the Public Interest.In that study,participants aged 15 years and above were selected from 13 districts/counties of Tibet and Xinjiang using a multistage stratified random sampling method from 2015 to 2016.The investigation included questionnaires and physical examinations,meanwhile,participants aged 35 years and above also had laboratory tests of fasting blood glucose and lipids,as well as echocardiography.The participants aged 35 years and above were selected for analysis in our study.Metabolic risk factors(MRFs)in our study were defined as central obesity/abdominal obesity(CO),hyperglycemia(HG),high blood pressure(HBP),high triglyceride(HTG)and low high-density lipoprotein cholesterol(LHDL-C).Based on the clustering of MRFs,the participants were divided into three groups as single MRF group(CGA),two MRFs group(CGB),and≥3 MRFs group(CGC).There were 31 combinations according to the content of each MRF.The status of different clustering and combinations of MRFs in the whole population,Tibetan and Xinjiang population were described.The prevalence of LVDD in different clustering and combinations of MRFs was calculated for the whole population,the population in Tibet and Xinjiang,respectively.Multivariate logistic regression model was used to calculated the risk of LVDD in different clustering and combinations of MRFs after adjusting for age,sex,residence altitude,ethnicity,smoking status,alcohol consumption,education,urban and rural area,family history of cardiovascular disease,total cholesterol and low-density lipoprotein cholesterol.SAS 9.4 statistical software was used for data analysis,and two-side P<0.05 was considered statistically significant.ResultsThe research subjects finally included in our study were 5,816,including 1,958 in Tibet and 3,858 in Xinjiang.Among the whole population,those without MRF,CGA,CGB and CGC accounted for 23.0%,33.4%,29.0%and 14.6%,respectively;it was 20.6%,34.8%,34.7%and 9,9%in Tibet,respectively;24.2%,32.8%,26,1%and 16.9%in Xinjiang,respectively.In the CGA population,people with HBP(48.2%)had the highest proportion in Tibet,CO(43.0%)in Xinjiang,and CO(43.7%)in the whole population.In the CGB population,the combination of CO+HBP was the highest proportion in the whole population,as well as in Tibet and Xinjiang;in the CGC population,so did the combination of CO+HBP+HTG.For all the 31 kinds of combinations of MRFs,CO+HBP had the highest proportion in Tibet,as well as in Xinjiang.and the whole population,the proportion were 33.9%,20.1%and 24.9%,respectively.The prevalence of LVDD in the whole participants was 33.4%;it was 34.1%and 33.1%in Tibet and Xinjiang(P=0.473).In Tibet,the prevalence of LVDD among people without MRF,CGA,CGB and CGC were 15.6%,31.0%,44.5%and 46.7%,respectively;it was 22.6%,31.7%,40.2%and 40.1%in Xinjiang,respectively;20.5%,31.5%,41.9%and 41.6%in the whole population,respectively.The results of multivariate logistic regression analysis showed that the risk of LVDD elevated with the number increase of MRFs.Among the whole population,compared with those without MRF,people in CGA,CGB and CGC had elevated risk of LVDD,the OR(95%CI)were 1.513(1.269～1.804)、2.089(1.688～2.585)and 2.093(1.749～2.505),respectively;it was 2.072(1.467～2.925),3.436(2.443～4.832)and 4.344(2.798～6.744)in Tibet,respectively,546(1.246～1.917),1.865(1.439～2.416)and 2.086(1.661～2.621)in Xinjiang,respectively.The combination with the highest risk of LVDD was HG+HBP(OR=6.226,95%CI:2.111～18.364)in Tibet,and CO+HBP(OR=2.872,95%CI:2.213～3.728)in Xinjiang.ConclusionThe most common combination of MRFs was CO+HBP both in Tibet and Xinjiang.In Tibet,HG+HBP had the highest risk of LVDD,and the combination in Xinjiang was CO+HBP.These high-risk groups should be targeted with focused interventions to reduce the risk.