The relationship between visceral adiposity and left ventricular diastolic function: Results from the Baltimore Longitudinal Study of Aging
The relationship between visceral adiposity and left ventricular diastolic function: Results from the Baltimore Longitudinal Study of Aging
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DOI：
10.1016/j.numecd.2013.04.003
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发表时间：
2013-12-01
影响因子：
3.9
通讯作者：
Ferrucci, L.
中科院分区：
文献类型：
--
作者：
Canepa, M.;Strait, J. B.;Ferrucci, L.
背景和目标：目前尚不清楚皮下和内脏脂肪是否与左心室舒张功能随年龄增长而下降有差异相关性。本研究试图检验这一假设，即年龄相关的局部脂肪分布变化解释了左室舒张功能的变化，并探讨了这种关联的潜在介质。方法和结果：在这项横断面研究中，我们评估了843名参与巴尔的摩老龄化纵向研究的参与者，包括超声心动图、双能X线吸收测定法（DEXA）、在同一次访视时进行腹部计算机断层扫描（CT）和血液检查。以左室舒张功能参数（E/A比值、Em和Em/Am比值）和左室充盈压（E/Em比值）评价左室舒张功能。全身脂肪由DEXA计算，而内脏和皮下脂肪由腹部CT确定。在调整人口统计学、心血管危险因素、抗高血压药物、体力活动和LV质量的多变量模型中，内脏和皮下脂肪均与LV舒张功能障碍相关。当这两种肥胖指标同时纳入同一模型时，只有内脏脂肪与左室舒张功能障碍显著相关。甘油三酯和性激素结合球蛋白，而不是脂联素和瘦素，被发现是内脏脂肪和左室舒张功能之间关系的重要介质，解释了28-47%的关联。Bootstrapping分析证实了这些findings.Conclusions的意义：增加内脏肥胖与左室舒张功能障碍，可能通过代谢途径，涉及血脂和异位脂肪堆积，而不是脂肪因子。由爱思唯尔公司出版
Background and aims: It is unclear whether subcutaneous and visceral fat are differentially correlated to the decline in left ventricular (LV) diastolic function with aging. This study sought to examine the hypothesis that age-related changes in the regional fat distribution account for changes in LV diastolic function and to explore potential mediators of this association.Methods and results: In this cross-sectional study, we evaluated 843 participants of the Baltimore Longitudinal Study of Aging with echocardiogram, dual-energy X-ray absorptiometry (DEXA), abdominal computed tomography (CT) and blood tests performed at the same visit. LV diastolic function was assessed by parameters of LV relaxation (E/A ratio, Em and Em/Am ratio) and LV filling pressures (E/Em ratio). Total body fat was computed by DEXA, while visceral and subcutaneous fat were determined from abdominal CT. In multivariate models adjusted for demographics, cardiovascular risk factors, antihypertensive medications, physical activity and LV mass, both visceral and subcutaneous fat were associated with LV diastolic dysfunction. When both measures of adiposity were simultaneously included in the same model, only visceral fat was significantly associated with LV diastolic dysfunction. Triglycerides and sex-hormone binding globulin, but not adiponectin and leptin, were found to be significant mediators of the relationship between visceral fat and LV diastolic function, explaining 28-47% of the association. Bootstrapping analyses confirmed the significance of these findings.Conclusions: Increased visceral adiposity is associated with LV diastolic dysfunction, possibly through a metabolic pathway involving blood lipids and ectopic fat accumulation rather than adipokines. Published by Elsevier B.V.