Abstract P244: Combined Measures of Total and Abdominal Adiposity and the Likelihood of Subclinical Myocardial Damage

Abstract

Background: Obesity has been independently associated with subclinical myocardial damage. Both body mass index (BMI) and waist circumference (WC) are recommended for cardiovascular risk assessment, and they provide complementary information about heart failure (HF) risk. However, their combined relationship with subclinical myocardial damage is presently unknown. Hypothesis: We hypothesized that high measures of both BMI and WC would have the strongest association with subclinical myocardial damage, as indexed by a high-sensitivity assay for cardiac troponin T (hs-cTnT). Methods: We performed a cross-sectional analysis of 9,507 participants at ARIC Visit 4 (1996-99). We excluded individuals with prior cardiovascular disease, with BMI < 18.5 kg/m2 and those not of white or black race. We created tertiles of BMI and WC (sex-specific for WC). We used logistic regression to relate combined tertiles of BMI and WC to elevated hs-cTnT (> 14 ng/L) measured at Visit 4, after adjustment for confounding variables. Results: The mean age was 62 years (S.D. 6), 58% were female and 22% were black. After multivariable adjustment, each 1-SD higher of BMI (1.41 [95% CI: 1.30-1.53]) and WC (1.50 [95% CI: 1.37-1.63]) was associated with elevated hs-cTnT. In analyses using combined BMI and WC tertiles, higher WC was associated with trends towards higher associations with elevated hs-cTnT within each BMI tertile (Figure). Among those individuals in the highest 2 BMI tertiles, those who were also in the highest WC tertile demonstrated significant independent associations between the anthropometric measures and elevated hs-cTnT. Conversely, significant associations with elevated hs-cTnT were not seen for those individuals in higher BMI tertiles but lower WC tertiles. Conclusion: A combination of high BMI and WC is associated with myocardial damage more often than high BMI with lower WC. This supports using assessments of both total and abdominal adiposity to understand obesity-associated risk.