Diagnostic Imaging Center, Kuopio University Hospital, 70210, Kuopio, Finland.
University of Eastern Finland, Kuopio, Finland.
High Blood Press Cardiovasc Prev. 2024 Jul;31(4):389-399. doi: 10.1007/s40292-024-00659-9. Epub 2024 Jun 14.
Central obesity (CO), characterized by an increased waist circumference increases the risk of cardiovascular disease (CVD) and morbidity, yet the underlying mechanisms are not fully understood. CO is often associated with general obesity, hypertension, and abnormal glucose tolerance, confounding the independent contribution of CO to CVD.
We investigated the relationship of CO (without associated disorders) with left ventricular (LV) characteristics and intrathoracic adipose tissue (IAT) by cardiac magnetic resonance.
LV characteristics, epicardial (EAT), and mediastinal adipose tissue (MAT) were measured from 29 normoglycemic, normotensive males with CO but without general obesity (waist circumference >100 cm, body mass index (BMI) <30 kg/m) and 18 non-obese male controls.
LV maximal wall thickness (LVMWT) and IAT but not LV mass or volumes were increased in CO subjects compared to controls (LVMWT, 12.3±1.2 vs. 10.7±1.5 mm, p < 0.001; EAT, 5.5±3.0 vs. 2.2±2.0 cm, p = 0.001; MAT, 31.0±12.8 vs. 15.4±10.7 cm, p < 0.001). The LVMWT was ≥12 mm in 69% of subjects with CO and 22% of controls (p = 0.002). In CO suspects, EAT correlated inversely with LV end-diastolic volume index (r = - 0.403, p = 0.037) and LV stroke volume (SV) (r = - 0.425, p = 0.027). MAT correlated inversely with SV (r = - 0.427, p=0.026) and positively with LVMWT (r = 0.399, p = 0.035). Among CO subjects, the waist-to-hip ratio (WHR) was an independent predictor of LVMWT (B = 22.4, β = 0.617, p < 0.001). The optimal cut-off with Youden's index for LV hypertrophy was identified at WHR 0.98 (sensitivity 85%, specificity 89%).
CO independent of BMI is associated with LV hypertrophy and intrathoracic adipose tissue contributing to cardiovascular burden.
中央型肥胖（CO）的特征是腰围增加，增加了心血管疾病（CVD）和发病的风险，但其中的机制尚不完全清楚。CO 通常与全身肥胖、高血压和异常葡萄糖耐量有关，这使得 CO 对 CVD 的独立贡献变得复杂。
我们通过心脏磁共振检查，研究了 CO（无相关疾病）与左心室（LV）特征和胸腔内脂肪组织（IAT）之间的关系。
从 29 名血糖正常、血压正常的男性中测量了 LV 特征、心外膜（EAT）和纵隔脂肪组织（MAT），这些男性有 CO 但没有全身肥胖（腰围>100cm，BMI<30kg/m2），并与 18 名非肥胖男性对照。
与对照组相比，CO 受试者的 LV 最大壁厚度（LVMWT）和 IAT 增加，但 LV 质量或容量没有增加（LVMWT，12.3±1.2 vs. 10.7±1.5mm，p<0.001；EAT，5.5±3.0 vs. 2.2±2.0cm，p=0.001；MAT，31.0±12.8 vs. 15.4±10.7cm，p<0.001）。69%的 CO 受试者和 22%的对照组的 LVMWT≥12mm（p=0.002）。在 CO 可疑患者中，EAT 与 LV 舒张末期容积指数（r=-0.403，p=0.037）和 LV 每搏量（SV）（r=-0.425，p=0.027）呈负相关。MAT 与 SV（r=-0.427，p=0.026）呈负相关，与 LVMWT（r=0.399，p=0.035）呈正相关。在 CO 受试者中，腰臀比（WHR）是 LVMWT 的独立预测因子（B=22.4，β=0.617，p<0.001）。用 Youden 指数确定的 LV 肥厚的最佳截断值为 WHR0.98（灵敏度 85%，特异性 89%）。
与 BMI 无关的 CO 与 LV 肥厚和胸腔内脂肪组织有关，导致心血管负担增加。
