Centre for Translational Cardiovascular Imaging University College London London United Kingdom.
Department of Paediatrics University of Oxford, John Radcliffe Hospital Oxford United Kingdom.
J Am Heart Assoc. 2023 Aug;12(15):e030221. doi: 10.1161/JAHA.123.030221. Epub 2023 Jul 25.
Background Greater body mass index is associated with cardiovascular remodeling in adolescents. However, body mass index cannot differentiate between adipose and nonadipose tissues. We examined how visceral and subcutaneous adipose tissue are linked with markers of early cardiovascular remodeling, independently from nonadipose tissue. Methods and Results Whole-body magnetic resonance imaging was done in 82 adolescents (39 overweight/obese; 36 female; median age, 16.3 [interquartile range, 14.4-18.1] years) to measure body composition and cardiovascular remodeling markers. Left ventricular diastolic function was assessed by echocardiography. Waist, waist:height ratio, and body mass index scores were calculated. Residualized nonadipose tissue, subcutaneous adipose tissue, and visceral adipose tissue variables, uncorrelated with each other, were constructed using partial regression modeling to allow comparison of their individual contributions in a 3-compartment body composition model. Cardiovascular variables mostly related to nonadipose rather than adipose tissue. Nonadipose tissue was correlated positively with left ventricular mass (=0.81), end-diastolic volume (=0.70), stroke volume (=0.64), left ventricular mass:end-diastolic volume (=0.37), and systolic blood pressure (=0.35), and negatively with heart rate (=-0.33) (all <0.01). Subcutaneous adipose tissue was associated with worse left ventricular diastolic function (=-0.42 to -0.48, =0.0007-0.02) and higher heart rates (=0.34, =0.007) but linked with better systemic vascular resistance (=-0.35, =0.006). There were no significant relationships with visceral adipose tissue and no associations of any compartment with pulse wave velocity. Conclusions Simple anthropometry does not reflect independent effects of nonadipose tissue and subcutaneous adipose tissue on the adolescent cardiovascular system. This could result in normal cardiovascular adaptations to growth being misinterpreted as pathological sequelae of excess adiposity in studies reliant on such measures.
较大的体重指数与青少年心血管重构相关。然而,体重指数不能区分脂肪组织和非脂肪组织。我们研究了内脏和皮下脂肪组织与早期心血管重构标志物之间的关系,这些标志物是独立于非脂肪组织之外的。
对 82 名青少年(39 名超重/肥胖;36 名女性;中位年龄 16.3[四分位距 14.4-18.1]岁)进行全身磁共振成像,以测量身体成分和心血管重构标志物。通过超声心动图评估左心室舒张功能。计算腰围、腰围身高比和体重指数得分。使用偏回归建模构建彼此不相关的残差非脂肪组织、皮下脂肪组织和内脏脂肪组织变量,以允许在 3 隔室身体成分模型中比较它们各自的贡献。心血管变量主要与非脂肪组织而不是脂肪组织相关。非脂肪组织与左心室质量(=0.81)、舒张末期容积(=0.70)、每搏输出量(=0.64)、左心室质量/舒张末期容积(=0.37)和收缩压(=0.35)呈正相关,与心率(=-0.33)呈负相关(均<0.01)。皮下脂肪组织与较差的左心室舒张功能(=-0.42 至-0.48,=0.0007-0.02)和较高的心率(=0.34,=0.007)相关,但与较好的全身血管阻力(=-0.35,=0.006)相关。与内脏脂肪组织无显著关系,与脉搏波速度也无任何隔室关系。
简单的人体测量法不能反映非脂肪组织和皮下脂肪组织对青少年心血管系统的独立影响。在依赖这些指标的研究中,这可能导致正常的心血管生长适应被误解为肥胖的病理性后果。