Obesity and metabolic features associated with long-term developing diastolic dysfunction in an initially healthy population-based cohort
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Diastolic dysfunction (DD) is increasingly common. However, its metabolic determinants are poorly known. This study aims to determine which metabolic and inflammatory features predict DD in initially healthy adults.
We prospectively analyzed the association between metabolic features and DD in 728 initially healthy adults aged 30–60 from Eastern France enrolled in the STANISLAS population-based cohort. Clinical and biological cardiovascular features were collected at baseline (1994–1995). DD was assessed twenty years later (2011–2016) by echocardiography using current international guidelines. For replication purposes, 1463 subjects from the Malmö Preventive Project cohort were analyzed.
In the STANISLAS cohort, 191 subjects (26.2%) developed DD. In age-sex-adjusted logistic models, significant predictors of DD were body mass index (BMI, odds ratio for 1-standard-deviation increase (OR) 1.28, 95% CI 1.08–1.52), waist circumference (WC, OR 1.48, 95% CI 1.18–1.84), waist-hip ratio (OR 1.53, 95% CI 1.16–2.02), systolic blood pressure (OR 1.19, 95% CI 1.00–1.43) and triglycerides (TG, OR 1.18, 95% CI 1.00–1.40). Subjects with elevated WC (> 80th percentile) and TG (> 50th percentile) had a twofold higher DD risk (age-sex-adjusted odds ratio 2.00, 95% CI 1.20–3.31, P = 0.008), whereas no such interplay was observed for BMI. In the Malmö cohort, BMI was similarly associated with DD; participants with both elevated BMI and TG were at higher DD risk (age-sex-adjusted odds ratio 1.61, 95% CI 1.18–2.20, P = 0.002).
Subjects with elevated WC and TG may have a higher long-term DD risk. Prevention targeting visceral obesity may help reduce the incidence of DD.
KeywordsDiastolic dysfunction Visceral fat Triglycerides Blood pressure Healthy adults Cohort study
The authors thank the staff of the “Centre d’Investigation Clinique INSERM 1433, Pierre Drouin” and the Centre de Ressources Biologiques (CRB) Lorrain. They also thank the staff of the “Centre de Médecine Preventive” in charge of the first three visits. They thank Mr. Pierre Pothier for editing this manuscript.
The STANISLAS study was supported by grants from the CHU de Nancy, the Lorraine region, the 6th EU-FP Network of Excellence Ingenious HyperCare (#LSHM-CT-2006-037093), the 7th EU-FP MEDIA (FP7 #261409), the HOMAGE (FP7 #305507), the FIBRO-TARGETS (FP7 #602904) projects, and the French National Research Agency (ANR-15-RHUS-0004). The Malmö study was supported by grants from the Wallenberg Centre for Molecular Medicine (ALFSKANE-675271) and the Medical Faculty (ALFSKANE-432021/436111) of Lund University, the Skåne University Hospital, the Crafoord Foundation, the Ernhold Lundstroms Research Foundation, the Region Skåne, the Hulda and Conrad Mossfelt Foundation, the Southwest Skåne´s Diabetes Foundation, the Kocksa foundation, the Research Funds of Region Skåne and the Swedish Heart and Lung foundation (2015-0322).
Compliance with ethical standards
The Ethics Committee of the Lorraine region (Comité Consultatif de Protection des Personnes qui se prêtent à une Recherche Biomédicale de Lorraine, and Comité Consultatif de Protection des Personnes Est-III) approved the study, in agreement with French legislation on human biomedical research. Each subject gave his/her written informed consent to participate in this study.
Conflict of interest
The authors declare that they have no competing interests.
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