The Relationship Between Syndrome X and Left Ventricular Hypertrophy: The Impact Of Different Methods of Adjusting Left Ventricular Mass.
Left ventricular hypertrophy is associated with the various elements of the insulin resistance syndrome (Syndrome X) including insulin resistance, hypertension, diabetes, dyslipidemia and obesity. There is no current consensus on the correct method of adjusting left ventricular mass (LVM). Objective: To determine the variation in the relationship between left ventricular hypertrophy (LVH)and Syndrome X when LVM is adjusted for height, height 2.7 and body surface area (BSA) in a population based study. Methods:LVM was measured echocardiographically in 442 participants aged 35 to 65 years. Results: The prevalence of LVH ranged from 15.6% to 33.9% depending on adjustment method. The correlation between LVH and Syndrome X components varied by adjustment criteria and by sex. In men, LVH was only correlated with blood pressure and obesity measurements. In women, LVH was correlated with all Syndrome X components except HDL cholesterol. Regardless of adjustment method, women with Syndrome X were more likely to have LVH than those without Syndrome X, although the magnitude of the relationship varied by LVM adjustment (LVM/height 2.7 : OR 16.6, 95% CI: 6.7 41.1; LVM/BSA: OR 5.8, 95% CI: 2.6-12.9). In men, the relationship between Syndrome X and LVH was significant when LVM was adjusted for height 2.7 (OR 3.0, 95% CI: 1.4-6.7) but not when adjusted for BSA (OR 1.2, 95% CI: 0.4-3.5). Conclusions:Both the prevalence of LVH and the relationship between LVH and Syndrome X are dependent on the method used to adjust LVM. When LVM is adjusted for height 2.7 , LVH is more prevalent and the relationship with Syndrome X is stronger than when adjusted for BSA. Regardless of adjustment method, the relationship between Syndrome X and LVH is much stronger in women than men. The LVM adjustment method employed is important to take into account both in epidemiological studies and clinical practice.