Kénora Chau1,2,3, Nicolas Girerd4,5, Martin Magnusson6,7, Zohra Lamiral4, Erwan Bozec4, Ludovic Merckle4, Margret Leosdottir8, Erasmus Bachus9, Zied Frikha4, João Pedro Ferreira4,5, Jean-Pierre Després10,11, Patrick Rossignol4,5, Jean-Marc Boivin12,4,5, Faiez Zannad4,5. 1. Département de Médecine Générale, Université de Lorraine, Vandoeuvre-lès-Nancy, France. c.kenora@yahoo.fr. 2. INSERM, Centre d'Investigations Cliniques Plurithématique 1433, UMR 1116, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, Université de Lorraine and CHU de Nancy, 4 Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France. c.kenora@yahoo.fr. 3. F-CRIN INI-CRCT Cardiovascular and Renal Clinical Trialists, Nancy, France. c.kenora@yahoo.fr. 4. INSERM, Centre d'Investigations Cliniques Plurithématique 1433, UMR 1116, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, Université de Lorraine and CHU de Nancy, 4 Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France. 5. F-CRIN INI-CRCT Cardiovascular and Renal Clinical Trialists, Nancy, France. 6. Department of Clinical Sciences, Lund University, Malmö, Sweden. 7. Department of Cardiology, Skåne University Hospital, Lund University, Malmö, Sweden. 8. Department of Ischemic Heart Disease, Skåne University Hospital, Lund University, Malmö, Sweden. 9. Center of Emergency Medicine, Skåne University Hospital, Lund University, Malmö, Sweden. 10. Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Quebec, QC, Canada. 11. Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, QC, Canada. 12. Département de Médecine Générale, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
Abstract
BACKGROUND: Diastolic dysfunction (DD) is increasingly common. However, its metabolic determinants are poorly known. This study aims to determine which metabolic and inflammatory features predict DD in initially healthy adults. METHODS: We prospectively analyzed the association between metabolic features and DD in 728 initially healthy adults aged 30-60 from Eastern France enrolled in the STANISLAS population-based cohort. Clinical and biological cardiovascular features were collected at baseline (1994-1995). DD was assessed twenty years later (2011-2016) by echocardiography using current international guidelines. For replication purposes, 1463 subjects from the Malmö Preventive Project cohort were analyzed. RESULTS: In the STANISLAS cohort, 191 subjects (26.2%) developed DD. In age-sex-adjusted logistic models, significant predictors of DD were body mass index (BMI, odds ratio for 1-standard-deviation increase (OR) 1.28, 95% CI 1.08-1.52), waist circumference (WC, OR 1.48, 95% CI 1.18-1.84), waist-hip ratio (OR 1.53, 95% CI 1.16-2.02), systolic blood pressure (OR 1.19, 95% CI 1.00-1.43) and triglycerides (TG, OR 1.18, 95% CI 1.00-1.40). Subjects with elevated WC (> 80th percentile) and TG (> 50th percentile) had a twofold higher DD risk (age-sex-adjusted odds ratio 2.00, 95% CI 1.20-3.31, P = 0.008), whereas no such interplay was observed for BMI. In the Malmö cohort, BMI was similarly associated with DD; participants with both elevated BMI and TG were at higher DD risk (age-sex-adjusted odds ratio 1.61, 95% CI 1.18-2.20, P = 0.002). CONCLUSIONS: Subjects with elevated WC and TG may have a higher long-term DD risk. Prevention targeting visceral obesity may help reduce the incidence of DD.
BACKGROUND:Diastolic dysfunction (DD) is increasingly common. However, its metabolic determinants are poorly known. This study aims to determine which metabolic and inflammatory features predict DD in initially healthy adults. METHODS: We prospectively analyzed the association between metabolic features and DD in 728 initially healthy adults aged 30-60 from Eastern France enrolled in the STANISLAS population-based cohort. Clinical and biological cardiovascular features were collected at baseline (1994-1995). DD was assessed twenty years later (2011-2016) by echocardiography using current international guidelines. For replication purposes, 1463 subjects from the Malmö Preventive Project cohort were analyzed. RESULTS: In the STANISLAS cohort, 191 subjects (26.2%) developed DD. In age-sex-adjusted logistic models, significant predictors of DD were body mass index (BMI, odds ratio for 1-standard-deviation increase (OR) 1.28, 95% CI 1.08-1.52), waist circumference (WC, OR 1.48, 95% CI 1.18-1.84), waist-hip ratio (OR 1.53, 95% CI 1.16-2.02), systolic blood pressure (OR 1.19, 95% CI 1.00-1.43) and triglycerides (TG, OR 1.18, 95% CI 1.00-1.40). Subjects with elevated WC (> 80th percentile) and TG (> 50th percentile) had a twofold higher DD risk (age-sex-adjusted odds ratio 2.00, 95% CI 1.20-3.31, P = 0.008), whereas no such interplay was observed for BMI. In the Malmö cohort, BMI was similarly associated with DD; participants with both elevated BMI and TG were at higher DD risk (age-sex-adjusted odds ratio 1.61, 95% CI 1.18-2.20, P = 0.002). CONCLUSIONS: Subjects with elevated WC and TG may have a higher long-term DD risk. Prevention targeting visceral obesity may help reduce the incidence of DD.
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