Juri Park1, Nan Hee Kim2, Seong Hwan Kim3, Jin-Seok Kim4, Yong Hyun Kim4, Hong Euy Lim5, Eung Ju Kim5, Jin Oh Na5, Goo-Yeong Cho6, Inkyung Baik7, Doo Man Kim1, Dong Seop Choi8, Seung Ku Lee9, Chol Shin9. 1. Division of Endocrinology, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea. 2. Division of Endocrinology, Korea University Ansan Hospital, Ansan, Republic of Korea. 3. Divison of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea. Electronic address: cardioguy@korea.ac.kr. 4. Divison of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea. 5. Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea. 6. Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 7. Department of Foods and Nutrition, Kookmin University, Seoul, Republic of Korea. 8. Division of Endocrinology, Korea University Anam Hospital, Seoul, Republic of Korea. 9. Institute of Human Genomic Study, Korea University Ansan Hospital, Ansan, Republic of Korea.
Abstract
BACKGROUND: Obesity and low muscle mass may coexist as age-related changes in body composition. We aimed to investigate the effect of visceral adiposity and skeletal muscle mass on left ventricular (LV) structure and function in the general population. METHODS: A total of 1941 participants without known cardiovascular disease were enrolled from the Korean Genome and Epidemiology Study. Visceral fat area (VFA) was assessed by computed tomography. Appendicular skeletal muscle mass (ASM) was estimated by dual-energy X-ray absorptiometry and was used as a percentage of body weight (ASM/Wt). LV structure and function were assessed by tissue Doppler imaging (TDI) echocardiography. RESULTS: Across VFA tertiles, ASM increased, but ASM/Wt decreased (all P<0.001). In multivariate models adjusted for conventional cardiovascular risk factors, LV mass index and LV diastolic parameters, such as left atrial dimension, TDI Ea velocity, and E/Ea ratio, were significantly impaired as VFA increased. On the other hand, an increase in ASM/Wt was associated with a decrease in LV mass index and improvement of LV diastolic parameters. With regard to LV mass index and TDI Ea velocity, VFA and ASM/Wt showed synergistic effects (all P interaction<0.05). When both VFA and ASM/Wt were simultaneously included in the same model, both remained independent predictors of LV mass index and TDI Ea velocity. CONCLUSIONS: More visceral fat and less muscle mass are independently and synergistically associated with an increase in LV mass index and impairment of LV diastolic parameters. Further research is needed to explore the complex mechanisms underlying these associations.
BACKGROUND: Obesity and low muscle mass may coexist as age-related changes in body composition. We aimed to investigate the effect of visceral adiposity and skeletal muscle mass on left ventricular (LV) structure and function in the general population. METHODS: A total of 1941 participants without known cardiovascular disease were enrolled from the Korean Genome and Epidemiology Study. Visceral fat area (VFA) was assessed by computed tomography. Appendicular skeletal muscle mass (ASM) was estimated by dual-energy X-ray absorptiometry and was used as a percentage of body weight (ASM/Wt). LV structure and function were assessed by tissue Doppler imaging (TDI) echocardiography. RESULTS: Across VFA tertiles, ASM increased, but ASM/Wt decreased (all P<0.001). In multivariate models adjusted for conventional cardiovascular risk factors, LV mass index and LV diastolic parameters, such as left atrial dimension, TDI Ea velocity, and E/Ea ratio, were significantly impaired as VFA increased. On the other hand, an increase in ASM/Wt was associated with a decrease in LV mass index and improvement of LV diastolic parameters. With regard to LV mass index and TDI Ea velocity, VFA and ASM/Wt showed synergistic effects (all P interaction<0.05). When both VFA and ASM/Wt were simultaneously included in the same model, both remained independent predictors of LV mass index and TDI Ea velocity. CONCLUSIONS: More visceral fat and less muscle mass are independently and synergistically associated with an increase in LV mass index and impairment of LV diastolic parameters. Further research is needed to explore the complex mechanisms underlying these associations.
Authors: Mark J Haykowsky; Barbara J Nicklas; Peter H Brubaker; W Gregory Hundley; Tina E Brinkley; Bharathi Upadhya; J Thomas Becton; Michael D Nelson; Haiying Chen; Dalane W Kitzman Journal: JACC Heart Fail Date: 2018-07-11 Impact factor: 12.035
Authors: María Benlloch; María Cuerda Ballester; Eraci Drehmer; Jose Luis Platero; Sandra Carrera-Juliá; María Mar López-Rodríguez; Jose Joaquin Ceron; Asta Tvarijonaviciute; Marí Ángeles Navarro; Mari Luz Moreno; Jose Enrique de la Rubia Ortí Journal: Nutrients Date: 2020-12-10 Impact factor: 5.717