Sesha Satya Sagar Vankadari Venkata, Acharya Sourya, Kumar Sunil, Reddy Harshitha, Chavhan Roma, Reddy Nikhil
Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2025 Feb 7;17(2):e78716. doi: 10.7759/cureus.78716. eCollection 2025 Feb.
Background Obesity is a risk factor for metabolic syndrome, which is a combination of metabolic abnormalities leading to development of cardiovascular abnormalities. Based on factors such as body mass index and metabolic syndrome, specific phenotypes for obesity have been established. These include metabolically healthy obese (MHO), metabolically unhealthy non-obese (MUNO), metabolically unhealthy obese (MUO), and metabolically healthy non-obese (MHNO). Echocardiography is a standard, noninvasive modality that is widely used to assess cardiovascular function. A systematic review and meta-analysis of echocardiographic studies in adult obesity found that obese adults were 4.2 times more likely to have left ventricular hypertrophy than nonobese adults.This study was conducted with the aim of the echocardiographic assessment of cardiac function in various obesity phenotypes. Material and methods This observational study was done in a tertiary care hospital and conducted for a period of two years from August 2019 to August 2021. Anthropometric data was obtained and metabolic parameters were estimated. After obtaining institutional ethical clearance, 400 patients were categorized into four groups of 100 based on their obesity phenotypes: MUO, MHO, MUNO, and 100 age- and sex-matched non-obese metabolically healthy individuals (MHNO) as controls. Echocardiographic assessment such as systolic and diastolic dysfunction was studied among above mentioned obesity phenotypes. The data was analysed using appropriate statistical significance tests. Results The mean BMI was highest in the MUO group (30.07 ±2.53), followed by MHO (28.79±2.3), and lowest in the MHNO group (22.77±1.13). The proportion of patients with Grade II diastolic dysfunction was higher in MUO patients (43%) compared to MHO patients (12%) and MUNO patients (16%). In contrast, the proportion of patients with Grade I diastolic dysfunction was lower in MUO patients (46%) compared to MHO patients (55%) and MUNO patients (57%). Systolic dysfunction in metabolically healthy non-obese (MHNO) patients (57.97 ± 2.34) was significantly higher than in MHO patients (51.83 ± 4.66, p < 0.0001), MUNO patients (51.49 ± 4.64, p < 0.0001), and MUO patients (49.9 ± 3.65, p < 0.0001). The proportion of patients with Grade II diastolic dysfunction was higher in MUO (43%) compared to MHO (12%) and MUNO (16%). In contrast, the proportion of patients with Grade I diastolic dysfunction was lower in MUO (46%) when compared to MHO (55%) and MUNO (57%). Systolic dysfunction in MHNO (57.97±2.34) was significantly higher as compared to MHO (51.83±4.66, p-value<.0001), MUNO (51.49±4.64, p-value<0.0001) and MUO (49.9±3.65, p-value<0.0001). Conclusion Cardiac function abnormalities in various phenotypes exhibit a significant positive correlation, including ventricular systolic and diastolic dysfunctions. Therefore, multidisciplinary management of all obesity phenotypes should be initiated as early as possible to prevent future cardiovascular morbidity and mortality.
肥胖是代谢综合征的一个危险因素，代谢综合征是导致心血管异常的多种代谢异常的组合。基于体重指数和代谢综合征等因素，已确定了肥胖的特定表型。这些表型包括代谢健康的肥胖者（MHO）、代谢不健康的非肥胖者（MUNO）、代谢不健康的肥胖者（MUO）和代谢健康的非肥胖者（MHNO）。超声心动图是一种标准的非侵入性检查方法，广泛用于评估心血管功能。一项针对成人肥胖的超声心动图研究的系统评价和荟萃分析发现，肥胖成年人发生左心室肥厚的可能性是非肥胖成年人的4.2倍。本研究旨在通过超声心动图评估不同肥胖表型的心脏功能。
本观察性研究在一家三级护理医院进行，从2019年8月至2021年8月为期两年。获取人体测量数据并估算代谢参数。获得机构伦理批准后，根据肥胖表型将400例患者分为四组，每组100例：MUO、MHO、MUNO，以及100名年龄和性别匹配的代谢健康的非肥胖个体（MHNO）作为对照组。在上述肥胖表型中研究了诸如收缩和舒张功能障碍等超声心动图评估指标。使用适当的统计学显著性检验对数据进行分析。
MUO组的平均BMI最高（30.07±2.53），其次是MHO组（28.79±2.3），MHNO组最低（22.77±1.13）。MUO患者中II级舒张功能障碍患者的比例（43%）高于MHO患者（12%）和MUNO患者（16%）。相比之下，MUO患者中I级舒张功能障碍患者的比例（46%）低于MHO患者（55%）和MUNO患者（57%）。代谢健康的非肥胖（MHNO）患者的收缩功能障碍（57.97±2.34）显著高于MHO患者（51.83±4.66，p<0.0001）、MUNO患者（51.49±4.64，p<0.0001）和MUO患者（49.9±3.65，p<0.0001）。MUO患者中II级舒张功能障碍患者的比例（43%）高于MHO患者（12%）和MUNO患者（16%）。相比之下，MUO患者中I级舒张功能障碍患者的比例（46%）低于MHO患者（55%）和MUNO患者（57%）。与MHO患者（51.83±4.66，p值<0.0001）、MUNO患者（51.49±4.64，p值<0.0001）和MUO患者（49.9±3.65，p值<0.0001）相比，MHNO患者的收缩功能障碍（57.97±2.34）显著更高。
不同表型的心脏功能异常呈现显著正相关，包括心室收缩和舒张功能障碍。因此，应尽早对所有肥胖表型进行多学科管理，以预防未来的心血管发病率和死亡率。
