Association of the degree of adiposity and duration of obesity with measures of cardiac structure and function: the CARDIA study.

Abstract

OBJECTIVEExamine whether there are independent influences of a greater degree of adiposity and longer duration of obesity on cardiac structure and function.METHODSParticipants of CARDIA were 18-30 years when they underwent a baseline examination in 1985-86. Seven follow-up examinations were conducted every 2-5 years.RESULTSAmong 2,547 participants who underwent an echocardiogram at the year 25 examination and were not obese at baseline, 34.4% and 35.5% were overall (BMI ≥30 kg/m2) and abdominally obese (waist circumference: men: >102 cm; women: >88 cm) at year 25, respectively. A greater degree of overall and abdominal adiposity at year 25 were each associated with a greater left ventricular (LV) mass (p<0.001), LV volume (p<0.001), LV mass-to-volume ratio (p<0.001), left atrial dimension (p<0.001), and ejection fraction (p<0.05) after adjustment for duration of obesity and other risk factors. In contrast, a longer duration of overall obesity was associated with a greater LV mass (p=0.003) and a trend for a lower ejection fraction (p=0.07).CONCLUSIONSA greater degree of adiposity is strongly associated with concentric LV remodeling in midlife, while the cumulative effects of a longer duration of overall obesity during young adulthood contribute to concentric remodeling predominantly by increasing LV mass.