Background Data regarding the metabolic risk factors clustering on the risk of left ventricular diastolic dysfunction ( LVDD ) are lacking among people living at high altitude and under hypoxic conditions. In this study, we explored the association between metabolic risk factor clustering and LVDD among the Tibetan population of China. Methods and Results We conducted a cross-sectional survey in a representative sample of 1963 Tibetans in 2014 to 2016. Grading LVDD was based on recommendations for the evaluation of LV diastolic function by echocardiography (2009). The prevalence of LVDD among 1963 participants (mean age: 51.51 years, 41.11% male) was 34.39%. Odds ratios (95% CI ) of LVDD for the 1, 2, and 3 to 5 risk factors clustering were 1.45 (0.96-2.17), 2.68 (1.8-3.98), and 2.9 (1.9-4.43), respectively ( P for trend <0.001). The association between metabolic risk factors clustering and LVDD was much more pronounced in the middle-aged group than in the elderly ( P for interaction=0.0170). High altitude was one of the major independent risk factors for LVDD ; however, habitation altitude had no significant effect on the association between metabolic risk factors and LVDD ( P for interaction=0.1022). The multivariable dominance analysis indicated that abdominal obesity, hypertension, and elevated blood glucose were the significant contributors to LVDD . Conclusions There was a significant positive association between the metabolic risk factor clustering number and LVDD among a population living at high altitude, especially in middle-aged adults. However, habitation altitude itself has no significant effect on the association between metabolic risk factors and LVDD .
Keywords: Tibet; cluster; left ventricular diastolic dysfunction; metabolic; risk factor.