Diverse Adiposity and Atrio-Ventricular Dysfunction across Obesity Phenotypes: Implication of Epicardial Fat Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Participants
2.2. Laboratory Data, Cardiac Biomarkers and HOMA-IR Analysis
2.3. Definition of Metabolic Health and Obesity Phenotype
- (1)
- Systolic blood pressure ≥ 13.0 mmHg, diastolic blood pressure ≥ 85 mmHg;
- (2)
- Triglycerides (TG) ≥150 mg/dL;
- (3)
- High density lipoprotein (HDL-c) <40 mg/dL in men and <50 mg/dL in women;
- (4)
2.4. Assessment of Epicardial Adipose Tissue (EAT)
2.5. Body Fat Composition Assessment
2.6. Conventional Echocardiography and Diastolic Functional Indices
2.7. Two-Dimensional Speckle-Tracking Analysis Protocol
2.8. Determination of Clinical Endpoints
2.9. Statistical Analysis
3. Results
3.1. Baseline Demographics, Metabolic Profiles and Adiposity Measures
3.2. Associations of EAT and Metabolic Abnormalities with Atrio-Eentricular Mechanics
3.3. Association of Obesity Phenotypes and EAT with Clinical Outcomes
4. Discussion
4.1. Summary of Study Results
4.2. Utilization of Visceral Adiposity in Redefining Cardiometabolic Obesity
4.3. Effect of EAT Burden on Ventricular Remodeling and Dysfunction
4.4. Effect of EAT Burden on Atrial Remodeling and Dysfunction
4.5. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total (n = 2944) | Normal-Weight (BMI < 23 kg/m2) | Overweight/Obese (BMI ≥ 23 kg/m2) | p-Value | ||
---|---|---|---|---|---|
MHNW (n = 566) | MUNW (n = 555) | MHO (n = 289) | MUO (n = 1534) | ||
Demographic/Anthropometric Data | |||||
Age, years | 44.55 ± 9.88 | 49.25 ± 10.13 * | 45.36 ± 9.09† | 48.17 ± 9.81 *# | <0.001 |
Males (%) | 217 (38.3%) | 332 (59.8%) | 204 (70.6%) | 1209 (78.8%) | <0.001 |
Weight, kg | 55.9 ± 7.1 | 58.8 ± 7.5 * | 68.1 ± 7.8 *† | 73.8 ± 10.7 *†# | <0.001 |
BMI, kg/m2 | 20.83 ± 1.26 | 21.45 ± 1.26 * | 24.46 ± 1.62 *† | 26.23 ± 2.7 *†# | <0.001 |
WC, cm | 73.17 ± 5.55 | 77.4 ± 6.05 * | 84.71 ± 5.59 *† | 88.14 ± 8.08 *†# | <0.001 |
Abnormal WC (%) | 36 (6.4%) | 39 (7.0%) | 108 (37.4%) | 715 (46.6%) | <0.001 |
WH ratio | 0.81 ± 0.06 | 0.85 ± 0.06 * | 0.85 ± 0.05 * | 0.90 ± 0.06 *†# | <0.001 |
WHt ratio | 0.45 ± 0.03 | 0.46 ± 0.03 * | 0.51 ± 0.04 *† | 0.53 ± 0.04 *† | <0.001 |
BF (%) | 22.77 ± 4.82 | 22.84 ± 5.08 | 24.87 ± 5.03 *† | 27.91 ± 6.3 *†# | <0.001 |
BSA (m2) | 1.71 ± 0.15 | 1.76 ± 0.15 * | 1.91 ± 0.15 *† | 1.99 ± 0.18 *†# | <0.001 |
SBP, mmHg | 109.22 ± 10.55 | 121.2 ± 15.45 * | 114.03 ± 9.58 *† | 124.97 ± 15.52 *†# | <0.001 |
DBP, mmHg | 66.9 ± 7.69 | 73.77 ± 10.09 * | 70.57 ± 7.26 *† | 77.14 ± 9.98 *†# | <0.001 |
Pulse rate, beats/min | 71.41 ± 11.24 | 74.58 ± 10.84 * | 70.29 ± 11.01† | 74 ± 10.5 *# | <0.001 |
Active Smoking (%) | 26 (4.6%) | 51 (9.2%) | 20 (6.9%) | 158 (10.3%) | <0.001 |
Laboratory Data | |||||
Fasting sugar, mg/dl | 89.8 ± 5.86 | 98.72 ± 15.14 * | 91.96 ± 5.23† | 101.21 ± 16.79 *†# | <0.001 |
HOMA-IR | 1.14 ± 0.6 | 1.54 ± 1.0 * | 1.42 ± 0.79 | 2.25 ± 1.63 *†# | <0.001 |
Total cholesterol, mg/dl | 197.18 ± 34.36 | 204.53 ± 39.63 * | 201.83 ± 32.62 | 207.01 ± 36.61 * | <0.001 |
TG, mg/dl | 79.95 ± 26.63 | 130.87 ± 103.17 * | 91.56 ± 26.62 † | 159.12 ± 91.09 *†# | <0.001 |
LDL-c, mg/dl | 121.5 ± 31.63 | 131.8 ± 35.11 * | 132.11 ± 31.8 * | 137.68 ± 32.85 *† | <0.001 |
HDL-c, mg/dl | 66.98 ± 14.82 | 56.17 ± 15.02 * | 59.23 ± 12.1 *† | 48.99 ± 12.78 *†# | <0.001 |
eGFR, ml/min/m2 | 94.36 ± 18.25 | 91.67 ± 17.82 * | 89.33 ± 13.17 * | 87.84 ± 15.85 *† | <0.001 |
Biomarkers | |||||
NT-proBNP, pg/ml | 39.56 ± 32.77 | 43.48 ± 70.98 | 30.17 ± 27.58 *† | 31.36 ± 30.3 *† | <0.001 |
hs-CRP, mg/dl | 0.10 ± 0.17 | 0.19 ± 0.39 * | 0.16 ± 0.32 | 0.23 ± 0.34 *# | <0.001 |
Total (n = 2944) | Normal-Weight (BMI <23 kg/m2) | Overweight/Obese (BMI ≥ 23 kg/m2) | p-Value | ||
---|---|---|---|---|---|
MHNW (n = 566) | MUNW (n = 555) | MHO (n = 289) | MUO (n = 1534) | ||
EAT, mm | 5.35 ± 1.13 | 6.18 ± 1.01 * | 6.25 ± 0.99 * | 6.48 ± 0.93 *†# | <0.001 |
EATi, mm/m2 | 3.14 ± 0.70 | 3.53 ± 0.65 * | 3.29 ± 0.56 *† | 3.28 ± 0.55 *† | <0.001 |
LVST, mm | 8.2 ± 1.1 | 8.5 ± 1.2 * | 8.8 ± 1.1 *† | 9.2 ± 1.2 *†# | <0.001 |
LVPT, mm | 8.14 ± 1.01 | 8.5 ± 1.08 * | 8.82 ± 1.03 *† | 9.16 ± 1.12 *†# | <0.001 |
LVEDV, ml | 66.36 ± 14.99 | 69.08 ± 15.5 * | 79.14 ± 16.66 *† | 81.44 ± 16.68 *† | <0.001 |
LVM, gm | 117.7 ± 27.46 | 126.63 ± 30.44 * | 142.06 ± 28.9 4*† | 150.55 ± 33.13 *†# | <0.001 |
LVMi (Ht2.7), gm/m2.7 | 31.2 ± 7.15 | 32.73 ± 8.19 * | 35.88 ± 7.54 *† | 37.65 ± 9.18 *†# | <0.001 |
LAV(max), ml | 23.56 ± 8.21 | 26.53 ± 9.6 * | 29.3 ± 8.93 *† | 34.77 ± 12.5 *†# | <0.001 |
LAV(min), ml | 9.63 ± 4.02 | 10.87 ± 4.57 * | 12.32 ± 4.8 *† | 14.87 ± 6.35 *†# | <0.001 |
LAEF (%) | 59.1 ± 12.61 | 58.39 ± 12.65 | 58.08 ± 11.6 | 57.33 ± 12.4 * | 0.03 |
LAVi (BSA), ml/m2 | 14.4 ± 4.9 | 14.9 ± 5.7 | 15.9 ± 4.6 * | 16.9 ± 6.0 *† | <0.001 |
LAVi > 34 mL/m2 (%) | 6 (1.2%) | 10 (1.7%) | 4 (1.5%) | 37 (2.4%) | 0.29 |
DT, ms | 201.8 ± 33.42 | 202.42 ± 32.96 | 201.1 ± 35.74 | 201.59 ± 34.13 | 0.83 |
IVRT, ms | 85.19 ± 12.84 | 88.08 ± 12.64 * | 87.85 ± 11.9 * | 89.5 ± 14.25* | <0.001 |
E/A ratio | 1.52 ± 0.44 | 1.3 ± 0.42 * | 1.38 ± 0.44 *† | 1.21 ± 0.37 *†# | <0.001 |
LV e’, cm/sec | 11.05 ± 2.29 | 9.9 ± 2.22 * | 10.26 ± 2.12 * | 9.2 ± 2.11 *†# | <0.001 |
LV s’, cm/sec | 8.68 ± 1.5 | 8.49 ± 1.49 | 8.49 ± 1.36 | 8.41 ± 1.42 * | 0.005 |
LV E/e’ ratio | 6.95 ± 1.86 | 7.51 ± 2.25 * | 7.03 ± 1.8 † | 7.75 ± 2.36 *# | <0.001 |
GLS (%) | 21.35 ± 1.89 | 20.6 ± 1.74 * | 20.43 ± 1.77 * | 19.84 ± 1.68 *†# | <0.001 |
GLS < 18% (%) | 15 (2.7%) | 26 (4.7%) | 11 (3.8%) | 163 (10.6%) | <0.001 |
PALS (%) | 42.18 ± 7.45 | 39.21 ± 7.54 * | 37.8 ± 7.39 * | 36.32 ± 7.8 *†# | <0.001 |
PALS < 23% (%) | 3 (0.5%) | 8 (1.4%) | 7 (2.4%) | 62 (4.0%) | <0.001 |
ALSRsyst | 1.85 ± 0.37 | 1.77 ± 0.39 * | 1.64 ± 0.34 *† | 1.62 ± 0.36 *† | <0.001 |
ALSRearly | 2.21 ± 0.51 | 1.94 ± 0.54 * | 1.91 ± 0.48 * | 1.63 ± 0.47 *†# | <0.001 |
ALSRlate | 1.97 ± 0.48 | 2.06 ± 0.47 * | 1.93 ± 0.43 † | 2.02 ± 0.49 # | 0.001 |
LAstiff | 0.17 ± 0.06 | 0.20 ± 0.09 * | 0.20 ± 0.07 * | 0.23 ± 0.11 *†# | <0.001 |
LV Indices | LV s’ | LV e’ | E/e’ | GLS | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pearson’s R | −0.08 | −0.27 | 0.14 | −0.27 | |||||||||
Regression models | Coef. | 95% CI | p | Coef. | 95% CI | p | Coef. | 95% CI | p | Coef. | 95% CI | p | |
Uni-variate | −0.11 | −0.16; −0.06 | <0.001 | −0.58 | −0.66; −0.5 | <0.001 | 0.3 | 0.22; 0.37 | <0.001 | −0.47 | −0.53; −0.41 | <0.001 | |
Multi-variate | |||||||||||||
Model 1 (+ Age) | −0.02 | −0.07; 0.03 | 0.44 | −0.33 | −0.39; −0.26 | <0.001 | 0.13 | 0.06; 0.2 | <0.001 | −0.46 | −0.53; −0.4 | <0.001 | |
BMI-based | Age + BMI | 0.01 | −0.04; 0.06 | 0.73 | −0.15 | −0.22; −0.09 | <0.001 | 0.08 | 0.003; 0.16 | 0.04 | −0.3 | −0.36; −0.23 | <0.001 |
Age + BMI + CV | −0.003 | −0.05; 0.05 | 0.92 | −0.13 | −0.19; −0.06 | <0.001 | 0.09 | 0.02; 0.17 | 0.02 | −0.25 | −0.32; −0.19 | <0.001 | |
Age + BMI + CV + LVM | 0.01 | −0.04; 0.06 | 0.79 | −0.12 | −0.18; −0.05 | 0.001 | 0.08 | 0.01; 0.16 | 0.03 | −0.25 | −0.31; −0.19 | <0.001 | |
WC-based | Age + WC | −0.01 | −0.07; 0.04 | 0.61 | −0.17 | −0.23; −0.1 | <0.001 | 0.12 | 0.05; 0.2 | 0.002 | −0.28 | −0.35; −0.22 | <0.001 |
Age + WC + CV | −0.01 | −0.06; 0.04 | 0.72 | −0.14 | −0.2; −0.07 | <0.001 | 0.1 | 0.03; 0.18 | 0.007 | −0.26 | −0.32; −0.2 | <0.001 | |
Age + WC + CV + LVM | 0.004 | −0.05; 0.06 | 0.88 | −0.12 | −0.19; −0.06 | <0.001 | 0.09 | 0.01; 0.16 | 0.02 | −0.25 | −0.32; −0.19 | <0.001 | |
BF-based | Age + BF | 0.03 | −0.03; 0.08 | 0.33 | −0.27 | −0.33; −0.2 | <0.001 | 0.06 | −0.02; 0.13 | 0.13 | −0.45 | −0.51; −0.38 | <0.001 |
Age + BF + CV | −0.01 | −0.06; 0.05 | 0.84 | −0.13 | −0.19; −0.06 | <0.001 | 0.11 | 0.03; 0.18 | 0.005 | −0.24 | −0.31; −0.18 | <0.001 | |
Age + BF + CV + LVM | 0.01 | −0.04,0.06 | 0.74 | −0.11 | −0.18; −0.04 | 0.001 | 0.09 | 0.02,0.17 | 0.02 | −0.24 | −0.3; −0.17 | <0.001 |
LA Indices | PALS | ALSRsyst | ALSRearly | ALSRlate | LAstiff | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Pearson’s R | −0.26 | −0.17 | −0.33 | 0.04 | 0.24 | |||||||||||
Regression models | Coef. | 95% CI | p | Coef. | 95% CI | p | Coef. | 95% CI | p | Coef. | 95% CI | p | Coef. | 95% CI | p | |
Uni-variate | −1.99 | −2.26; −1.72 | <0.001 | −0.06 | −0.07; −0.05 | <0.001 | −0.17 | −0.18; −0.15 | <0.001 | 0.02 | 0.003; 0.04 | 0.02 | 0.022 | 0.018,0.025 | <0.001 | |
Multi-variate | ||||||||||||||||
Model 1 (+Age) | −1.68 | −1.95; −1.4 | <0.001 | −0.05 | −0.06; −0.04 | <0.001 | −0.11 | −0.13; −0.1 | <0.001 | 0.01 | −0.01; 0.03 | 0.31 | 0.015 | 0.011; 0.018 | <0.001 | |
BMI-based | Age + BMI | −1.05 | −1.33; −0.76 | <0.001 | −0.02 | −0.03; −0.004 | 0.01 | −0.05 | −0.07; −0.03 | <0.001 | 0.01 | −0.01; 0.03 | 0.21 | 0.009 | 0.006; 0.012 | <0.001 |
Age + BMI + CV | −0.98 | −1.27; −0.7 | <0.001 | −0.02 | −0.03; −0.01 | 0.005 | −0.04 | −0.06; −0.03 | <0.001 | 0.005 | −0.01; 0.02 | 0.63 | 0.009 | 0.006; 0.012 | <0.001 | |
Age + BMI + CV + LAV(max) | −0.88 | −1.16; −0.59 | <0.001 | −0.01 | −0.03; −0.001 | 0.04 | −0.04 | −0.06; −0.03 | <0.001 | 0.01 | −0.01; 0.03 | 0.21 | 0.007 | 0.004; 0.01 | <0.001 | |
WC-based | Age + WC | −1.13 | −1.41; −0.85 | <0.001 | −0.03 | −0.04; −0.02 | <0.001 | −0.06 | −0.08; −0.04 | <0.001 | 0.004 | −0.01; 0.02 | 0.69 | 0.011 | 0.008; 0.014 | <0.001 |
Age + WC + CV | −1.05 | −1.33; −0.77 | <0.001 | −0.03 | −0.04; −0.01 | <0.001 | −0.05 | −0.07; −0.04 | <0.001 | 0.001 | −0.02; 0.02 | 0.9 | 0.01 | 0.007; 0.013 | <0.001 | |
Age + WC + CV + LAV(max) | −0.91 | −1.19; −0.63 | <0.001 | −0.02 | −0.03; −0.01 | 0.006 | −0.05 | −0.06; −0.03 | <0.001 | 0.01 | −0.01; 0.03 | 0.28 | 0.007 | 0.004; 0.011 | <0.001 | |
BF-based | Age + BF | −1.45 | −1.72; −1.17 | <0.001 | −0.03 | −0.05; −0.02 | <0.001 | −0.09 | −0.11; −0.08 | <0.001 | 0.02 | 0.01; 0.04 | 0.008 | 0.01 | 0.007; 0.013 | <0.001 |
Age + BF + CV | −1.02 | −1.3; −0.73 | <0.001 | −0.02 | −0.04; −0.01 | 0.001 | −0.05 | −0.07; −0.04 | <0.001 | 0.01 | −0.01; 0.02 | 0.53 | 0.009 | 0.005; 0.012 | <0.001 | |
Age + BF + CV + LAV(max) | −0.88 | −1.17; −0.59 | <0.001 | −0.02 | −0.03; −0.002 | 0.02 | −0.05 | −0.06; −0.03 | <0.001 | 0.01 | −0.01; 0.03 | 0.16 | 0.006 | 0.003; 0.01 | <0.001 |
Models | Univariate Model | Multivariate Models | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Multivariate Model 1 | Multivariate Model 2 | Multivariate Model 3 | Multivariate Model 4 | |||||||
LV e’ | Coef. | p | Coef. | p | Coef. | p | Coef. | p | Coef. | p |
BP Abnormality | −1.18 | <0.001 | −1.03 | <0.001 | −0.9 | <0.001 | −0.49 | <0.001 | −0.36 | <0.001 |
Sugar Abnormality | −0.83 | <0.001 | −0.58 | <0.001 | −0.45 | <0.001 | −0.07 | 0.37 | −0.02 | 0.77 |
TG Abnormality | −0.91 | <0.001 | −0.7 | <0.001 | −0.57 | <0.001 | −0.66 | <0.001 | −0.63 | <0.001 |
HDL Abnormality | −0.46 | <0.001 | −0.19 | 0.1 | −0.1 | 0.37 | −0.2 | 0.03 | −0.13 | 0.14 |
EAT | −0.58 | <0.001 | — | — | −0.45 | <0.001 | −0.22 | <0.001 | −0.18 | <0.001 |
E/e’ | Coef. | p | Coef. | p | Coef. | p | Coef. | p | Coef. | p |
BP Abnormality | 0.67 | <0.001 | 0.64 | <0.001 | 0.57 | <0.001 | 0.45 | <0.001 | 0.39 | <0.001 |
Sugar Abnormality | 0.34 | <0.001 | 0.23 | 0.02 | 0.16 | 0.09 | 0.06 | 0.5 | 0.06 | 0.5 |
TG Abnormality | 0.17 | 0.08 | −0.03 | 0.8 | −0.1 | 0.34 | 0.25 | 0.008 | 0.26 | 0.005 |
HDL Abnormality | 0.39 | <0.001 | 0.39 | 0.001 | 0.34 | 0.002 | 0.3 | 0.003 | 0.25 | 0.02 |
EAT | 0.3 | <0.001 | — | — | 0.24 | <0.001 | 0.15 | <0.001 | 0.12 | 0.001 |
GLS, % | Coef. | p | Coef. | p | Coef. | p | Coef. | p | Coef. | p |
BP Abnormality | −0.72 | <0.001 | −0.62 | <0.001 | −0.5 | <0.001 | −0.37 | <0.001 | −0.27 | 0.01 |
Sugar Abnormality | −0.54 | <0.001 | −0.35 | <0.001 | −0.25 | 0.001 | −0.11 | 0.15 | −0.07 | 0.38 |
TG Abnormality | −0.84 | <0.001 | −0.68 | <0.001 | −0.57 | <0.001 | −0.32 | <0.001 | −0.29 | <0.001 |
HDL Abnormality | −0.5 | <0.001 | −0.23 | 0.01 | −0.16 | 0.08 | −0.25 | 0.005 | −0.21 | 0.02 |
EAT | −0.47 | <0.001 | — | — | −0.38 | <0.001 | −0.32 | <0.001 | −0.3 | <0.001 |
Models | Univariate Model | Multivariate Models | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Multivariate Model 1 | Multivariate Model 2 | Multivariate Model 3 | Multivariate Model 4 | |||||||
PALS, % | Coef. | p | Coef. | p | Coef. | p | Coef. | p | Coef. | p |
BP Abnormality | −2.34 | <0.001 | −1.98 | <0.001 | −1.47 | <0.001 | −0.91 | 0.006 | −0.86 | 0.01 |
Sugar Abnormality | −1.88 | <0.001 | −1.28 | <0.001 | −0.8 | 0.02 | −0.28 | 0.4 | −0.21 | 0.53 |
TG Abnormality | −2.59 | <0.001 | −2.08 | <0.001 | −1.58 | <0.001 | −1.55 | <0.001 | −1.48 | <0.001 |
HDL Abnormality | −1.48 | <0.001 | −0.65 | 0.12 | −0.3 | 0.45 | −0.47 | 0.23 | −0.36 | 0.37 |
EAT | −1.99 | <0.001 | — | — | −1.72 | <0.001 | −1.42 | <0.001 | −1.21 | <0.001 |
ALSRearly | Coef. | p | Coef. | p | Coef. | p | Coef. | p | Coef. | p |
BP Abnormality | −0.24 | <0.001 | −0.24 | <0.001 | −0.2 | <0.001 | −0.12 | <0.001 | −0.1 | <0.001 |
Sugar Abnormality | −0.24 | <0.001 | −0.19 | <0.001 | −0.15 | <0.001 | −0.08 | <0.001 | −0.07 | <0.001 |
TG Abnormality | −0.22 | <0.001 | −0.16 | <0.001 | −0.13 | <0.001 | −0.14 | <0.001 | −0.12 | <0.001 |
HDL Abnormality | −0.15 | <0.001 | −0.08 | 0.003 | −0.05 | 0.04 | −0.08 | 0.001 | −0.06 | 0.006 |
EAT | −0.16 | <0.001 | — | — | −0.13 | <0.001 | −0.09 | <0.001 | −0.07 | <0.001 |
LAstiff | Coef. | p | Coef. | p | Coef. | p | Coef. | p | Coef. | p |
BP Abnormality | 0.03 | <0.001 | 0.03 | <0.001 | 0.02 | <0.001 | 0.02 | <0.001 | 0.01 | 0.001 |
Sugar Abnormality | 0.02 | <0.001 | 0.02 | <0.001 | 0.01 | 0.005 | 0.005 | 0.23 | 0.004 | 0.23 |
TG Abnormality | 0.02 | <0.001 | 0.01 | 0.07 | 0.003 | 0.54 | 0.01 | 0.002 | 0.01 | 0.006 |
HDL Abnormality | 0.02 | <0.001 | 0.02 | <0.001 | 0.01 | 0.003 | 0.01 | 0.001 | 0.01 | 0.004 |
EAT | 0.02 | <0.001 | — | — | 0.02 | <0.001 | 0.01 | <0.001 | 0.01 | <0.001 |
Event Types | AF Event | HF Event | ||||||
---|---|---|---|---|---|---|---|---|
Obesity Phenotypes by BMI vs. Metabolic status | Rate (%) | aHR | (95% CI) | p-value | Rate (%) | aHR | (95% CI) | p-value |
Low BMI/metabolically healthy (MHNW) | 0.4 | 1 | (reference) | — | 0.6 | 1 | (reference) | — |
Low BMI/metabolically unhealthy (MUNW) | 1.1 | 1.3 | (0.2–7.0) | 0.75 | 2.1 | 3.2 | (1.0–11.9) | 0.04 |
High BMI/metabolically healthy (MHO) | 2.3 | 5.4 | (1.2–31.5) | 0.04 | 0.8 | 1.8 | (0.4–9.3) | 0.46 |
High BMI/metabolically unhealthy (MUO) | 3.8 | 5.7 | (1.7–30.6) | 0.02 | 3.6 | 5.3 | (1.5–18.5) | 0.01 |
Obesity Phenotypes by BMI vs. Visceral Fat | Rate (%) | aHR | (95% CI) | p-value | Rate (%) | aHR | (95% CI) | p-value |
Low BMI/low EAT (<7.0 mm) | 0.2 | 1 | (reference) | — | 0.8 | 1 | (reference) | — |
Low BMI/high EAT (≥7.0 mm) | 3.2 | 9.3 | (1.8−48.1) | 0.008 | 4.3 | 3.6 | (1.2−10.4) | 0.018 |
High BMI/low EAT (<7.0 mm) | 2.5 | 7.4 | (1.7–31.7) | 0.007 | 2.2 | 2.3 | (0.9–5.7) | 0.065 |
High BMI/high EAT (≥7.0 mm) | 5.6 | 13.8 | (3.3–59.9) | <0.001 | 4.8 | 4.2 | (1.7–10.2) | 0.002 |
NRI table for abnormal GLS (<18%) | ||
All, n = 2827 | Improvement in BMI/MU 4 Category | Improvement in BMI/EAT 4 Category |
GLS Normal | 93.7% | 91.1% |
GLS Abnormal | 6.3% | 8.1% |
NRI: 13.2%, p = 0.065 | ||
BMI ≥ 23 kg/m2, n = 1744 | Improvement in BMI/MU 4 Category | Improvement in BMI/EAT 4 Category |
GLS Normal | 92.1% | 88.7% |
GLS Abnormal | 7.9% | 11.3% |
NRI: 19.9%, p = 0.01 | ||
NRI table for HF event | ||
All, n = 2827 | Improvement in BMI/MU 4 Category | Improvement in BMI/EAT 4 Category |
Non-event | 97.8% | 97.2% |
With events | 2.2% | 2.8% |
NRI: 12.5%, p = 0.29 | ||
BMI ≥ 23 kg/m2, n = 1744 | Improvement in BMI/MU 4 Category | Improvement in BMI/EAT 4 Category |
Non-event | 97.3% | 96.1% |
With events | 2.7% | 3.9% |
NRI: 19.9%, p = 0.15 |
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Lai, Y.-H.; Liu, L.Y.-m.; Sung, K.-T.; Tsai, J.-P.; Huang, W.-H.; Yun, C.-H.; Lin, J.-L.; Chen, Y.-J.; Su, C.-H.; Hung, T.-C.; et al. Diverse Adiposity and Atrio-Ventricular Dysfunction across Obesity Phenotypes: Implication of Epicardial Fat Analysis. Diagnostics 2021, 11, 408. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030408
Lai Y-H, Liu LY-m, Sung K-T, Tsai J-P, Huang W-H, Yun C-H, Lin J-L, Chen Y-J, Su C-H, Hung T-C, et al. Diverse Adiposity and Atrio-Ventricular Dysfunction across Obesity Phenotypes: Implication of Epicardial Fat Analysis. Diagnostics. 2021; 11(3):408. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030408
Chicago/Turabian StyleLai, Yau-Huei, Lawrence Yu-min Liu, Kuo-Tzu Sung, Jui-Peng Tsai, Wen-Hung Huang, Chun-Ho Yun, Jiun-Lu Lin, Ying-Ju Chen, Cheng-Huang Su, Ta-Chuan Hung, and et al. 2021. "Diverse Adiposity and Atrio-Ventricular Dysfunction across Obesity Phenotypes: Implication of Epicardial Fat Analysis" Diagnostics 11, no. 3: 408. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11030408