Obesity

Association of metabolically healthy obesity in young adulthood with myocardial structure and function

Int J Obes (Lond)Published Prospective cohort study

Authors' conclusion

In this community-based cohort using data from the CARDIA study, obesity in young adulthood was significantly associated with LV hypertrophy, worse systolic and diastolic function regardless of metabolic status. Relationship of Baseline Metabolic Phenotypes with Young Adulthood and Midlife Cardiac Structure and Function. Adjusted for year 0 covariates: age, sex, race, educational level, smoking status, drinking status, and physical activity; metabolically healthy non-obesity was used as a reference category for comparison. † Criteria for metabolic syndrome are listed in Supplementary Table S6. MUN metabolically unhealthy non-obesity, MHO metabolically healthy obesity, LVMi left ventricular mass index, LVEF left ventricular ejection fraction, E/A early to late peak diastolic mitral flow velocity ratio, E/é mitral inflow velocity to early diastolic mitral annular velocity, CI confidence interval.

Study context

Population
CARDIA participants with echocardiography in young adulthood and middle age; baseline mean age 25 years, 56.4% women, 44.7% blackCARDIA study
Participants
3,066 participants
Exposure
Metabolic phenotypes in young adulthood (metabolically healthy obesity (MHO), MUN, metabolically unhealthy obesity (MUO)) vs metabolically healthy non-obesity (MHN)
Outcome
LV structure and function (LV mass index, E/é ratio, GLS)
Follow-up
After 25 years
Methodological detailscommunity-based, multiple linear regression, sensitivity analyses
  • Community-based
  • Multiple linear regression
  • Sensitivity analyses

Main finding

As reported in the abstract

25 years
MUN · worse left ventricular (LV) diastolic function
β (E/é ratio) 0.73 (95% CI 0.18–1.28)
MUN · worse systolic function
β (GLS) 0.60 (95% CI 0.08–1.12)
MHO · LV hypertrophy
β (LV mass index) 7.49 g/m² (95% CI 4.63–10.35)
MUO · LV hypertrophy
β (LV mass index) 18.23 g/m² (95% CI 12.47–23.99)
MHO · worse diastolic function
β (E/é ratio) 0.67 (95% CI 0.31–1.02)
MUO · worse diastolic function
β (E/é ratio) 1.47 (95% CI 0.79–2.14)
MHO · worse systolic function
β (GLS) 0.72 (95% CI 0.38–1.06)
MUO · worse systolic function
β (GLS) 1.35 (95% CI 0.64–2.05)

Observational data: associations, not effects.

Original publication

Association of metabolically healthy obesity in young adulthood with myocardial structure and function. Int J Obes (Lond). Published 10 March 2023. doi:10.1038/s41366-023-01288-3

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