Relative Fat-free Mass Deficiency and Left Ventricular Adaptation to Obesity: the Strong Heart Study

Overview

Journal Int J Cardiol

Publisher Elsevier

Specialty Cardiology & Vascular Diseases

Date 2012 Oct 16

PMID 23063139

Citations 16

Authors

Giovanni de Simone

Fabrizio Pasanisi

Aldo L Ferrara

Mary J Roman

Elisa T Lee

Franco Contaldo

Barbara V Howard

Richard B Devereux

Affiliations

Soon will be listed here.

Abstract

Background: Relative fat-free mass (FFM) deficiency (RFFMD) can also occur in obesity, but the impact on left ventricular (LV) mass is unknown.

Methods: We assessed relations among reduced FFM, obesity and LV mass in a population with high prevalence of obesity. Echocardiograms were performed in 2625 participants (1694 women, 1199 non-obese) of the Strong Heart Study cohort, free of prevalent cardiovascular disease and kidney failure. FFM was estimated by bioelectric impedance and analyzed in the non-obese subpopulation in relation with sex, BMI and waist-to-hip ratio (WHR). RFFMD was estimated in the obese subpopulation as the percent of observed/predicted FFM<20th percentile of the non-obese distribution.

Results: RFFMD was more frequent in women than men. LV mass indices (by either height(2.7) or FFM) were greater in obese with than in those without RFFMD, even after adjusting for sex and diabetes (both p<0.0001). The greater LV mass index in obesity with RFFMD was related mostly to increased LV diastolic dimension paralleling increased stroke index and cardiac index, in the presence of normal ejection fraction. RFFMD remained associated with greater LV mass index (p<0.0001) even independently of older age, greater BMI, higher systolic and lower diastolic blood pressure (all p<0.007), with negligible effect of sex, waist/hip ratio and diabetes.

Conclusion: In obese SHS participants, RFFMD is associated with higher levels of LV mass, an effect related to adiposity more than central fat distribution and typical of female gender. Biological mechanisms of this association have to be better explored.

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References

Dannenberg A, Levy D, Garrison R . Impact of age on echocardiographic left ventricular mass in a healthy population (the Framingham Study). Am J Cardiol. 1989; 64(16):1066-8. DOI: 10.1016/0002-9149(89)90816-3. View

Loomba-Albrecht L, Styne D . Effect of puberty on body composition. Curr Opin Endocrinol Diabetes Obes. 2009; 16(1):10-5. DOI: 10.1097/med.0b013e328320d54c. View

Howard B, Lee E, Cowan L, Fabsitz R, HOWARD W, Oopik A . Coronary heart disease prevalence and its relation to risk factors in American Indians. The Strong Heart Study. Am J Epidemiol. 1995; 142(3):254-68. DOI: 10.1093/oxfordjournals.aje.a117632. View

Stenholm S, Harris T, Rantanen T, Visser M, Kritchevsky S, Ferrucci L . Sarcopenic obesity: definition, cause and consequences. Curr Opin Clin Nutr Metab Care. 2008; 11(6):693-700. PMC: 2633408. DOI: 10.1097/MCO.0b013e328312c37d. View

Roubenoff R, Hughes V, Dallal G, Nelson M, Morganti C, Kehayias J . The effect of gender and body composition method on the apparent decline in lean mass-adjusted resting metabolic rate with age. J Gerontol A Biol Sci Med Sci. 2000; 55(12):M757-60. DOI: 10.1093/gerona/55.12.m757. View

Silva E, Flexa F, Zanella M . Abdominal obesity, insulin resistance and hypertension: impact on left ventricular mass and function in women. Arq Bras Cardiol. 2007; 89(2):77-82, 86-92. DOI: 10.1590/s0066-782x2007001400003. View

Devereux R, Alderman M . Role of preclinical cardiovascular disease in the evolution from risk factor exposure to development of morbid events. Circulation. 1993; 88(4 Pt 1):1444-55. DOI: 10.1161/01.cir.88.4.1444. View

Sahn D, DeMaria A, Kisslo J, Weyman A . Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978; 58(6):1072-83. DOI: 10.1161/01.cir.58.6.1072. View

de Simone G, Kizer J, Chinali M, Roman M, Bella J, Best L . Normalization for body size and population-attributable risk of left ventricular hypertrophy: the Strong Heart Study. Am J Hypertens. 2005; 18(2 Pt 1):191-6. DOI: 10.1016/j.amjhyper.2004.08.032. View

10.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View

11.

Howard B, Lee E, Cowan L, Devereux R, Galloway J, Go O . Rising tide of cardiovascular disease in American Indians. The Strong Heart Study. Circulation. 1999; 99(18):2389-95. DOI: 10.1161/01.cir.99.18.2389. View

12.

Schiller N, Shah P, Crawford M, DeMaria A, Devereux R, FEIGENBAUM H . Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989; 2(5):358-67. DOI: 10.1016/s0894-7317(89)80014-8. View

13.

Valentine R, Misic M, Rosengren K, Woods J, Evans E . Sex impacts the relation between body composition and physical function in older adults. Menopause. 2009; 16(3):518-23. PMC: 2844341. DOI: 10.1097/gme.0b013e31818c931f. View

14.

Newman A, Kupelian V, Visser M, Simonsick E, Goodpaster B, Nevitt M . Sarcopenia: alternative definitions and associations with lower extremity function. J Am Geriatr Soc. 2003; 51(11):1602-9. DOI: 10.1046/j.1532-5415.2003.51534.x. View

15.

Devereux R, Roman M, Paranicas M, OGrady M, Lee E, Welty T . Impact of diabetes on cardiac structure and function: the strong heart study. Circulation. 2000; 101(19):2271-6. DOI: 10.1161/01.cir.101.19.2271. View

16.

de Simone G, Devereux R, Chinali M, Roman M, Barac A, Panza J . Sex differences in obesity-related changes in left ventricular morphology: the Strong Heart Study. J Hypertens. 2011; 29(7):1431-8. PMC: 4139509. DOI: 10.1097/HJH.0b013e328347a093. View

17.

Schrager M, Metter E, Simonsick E, Ble A, Bandinelli S, Lauretani F . Sarcopenic obesity and inflammation in the InCHIANTI study. J Appl Physiol (1985). 2006; 102(3):919-25. PMC: 2645665. DOI: 10.1152/japplphysiol.00627.2006. View

18.

Cesari M, Kritchevsky S, Baumgartner R, Atkinson H, Penninx B, Lenchik L . Sarcopenia, obesity, and inflammation--results from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors study. Am J Clin Nutr. 2005; 82(2):428-34. DOI: 10.1093/ajcn.82.2.428. View

19.

Dewey F, Rosenthal D, Murphy Jr D, Froelicher V, Ashley E . Does size matter? Clinical applications of scaling cardiac size and function for body size. Circulation. 2008; 117(17):2279-87. DOI: 10.1161/CIRCULATIONAHA.107.736785. View

20.

De Simone G, Daniels S, Devereux R, Meyer R, Roman M, de Divitiis O . Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol. 1992; 20(5):1251-60. DOI: 10.1016/0735-1097(92)90385-z. View