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Liao YY, Wang D, Chu C, Man ZY, Wang Y, Ma Q, Chen C, Sun Y, Mu JJ. Long-term burden and increasing trends of body mass index are linked with adult hypertension through triglyceride-glucose index: A 30-year prospective cohort study. Nutr Metab Cardiovasc Dis 2024; 34:2134-2142. [PMID: 39003135 DOI: 10.1016/j.numecd.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/04/2024] [Accepted: 05/13/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND AND AIMS Insulin resistance (IR) has previously been associated with hypertension, and obesity is a risk factor for IR and hypertension. There is likely an association between body mass index (BMI) and risk for hypertension through the triglyceride-glucose (TyG) index but this relationship remains uncharacterized. METHODS AND RESULTS This study is based on the Hanzhong Adolescent Hypertension Cohort, which is an ongoing prospective study established in 1987. The TyG index was calculated as ln [fasting triglyceride (mg/dl) × fasting plasma glucose (mg/dl)/2]. The total area under the curve (AUCt) and incremental AUC (AUCi) were calculated as the long-term burden and trend of BMI, respectively. We found that BMI AUCt and BMI AUCi were significantly associated with the risk of adult hypertension, both without (RR = 1.30/1.31 for BMI AUCt/AUCi) and with (RR = 1.25/1.26 for BMI AUCt/AUCi) the inclusion of the TyG index as a covariate. Importantly, mediation analysis revealed that the TyG index mediated the BMI AUCt-SBP association (19.3%), the BMI AUCt-DBP association (22.7%), the BMI AUCi-SBP association (18.5%) and the BMI AUCi-DBP association (21.3%). Furthermore, the TyG index had a significant mediating effect of 15.9% on the BMI AUCt-hypertension association and 14.9% on the BMI AUCi-hypertension association. CONCLUSION These findings suggest that the TyG index plays an important mediating role in the association between the cumulative burden and increasing trends of BMI originating in childhood and the risk of hypertension in midlife. We emphasize that early weight management has the potential to reduce the burden of hypertension caused by IR. TRIAL REGISTRATION The study was clinically registered at the ClinicalTrials.gov (NCT02734472) and approved by the Academic Committee of the First Affiliated Hospital of Xi'an Jiaotong University (XJTU1AF2015LSL-047).
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Affiliation(s)
- Yue-Yuan Liao
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Dan Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Chao Chu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Zi-Yue Man
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Yang Wang
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Qiong Ma
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Chen Chen
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Yue Sun
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China
| | - Jian-Jun Mu
- Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an 710061, Shaanxi, China; International Joint Research Center for Cardiovascular Precision Medicine of Shaanxi Province, Xi'an, China.
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Saade Y, Deraz O, Chatzopoulou E, Rangé H, Boutouyrie P, Perier MC, Guibout C, Thomas F, Danchin N, Jouven X, Bouchard P, Empana JP. Recalled body silhouette trajectories over the lifespan and oral conditions in adulthood: A cross-sectional analysis of the Paris Prospective Study 3. Community Dent Oral Epidemiol 2024; 52:518-526. [PMID: 38273719 DOI: 10.1111/cdoe.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To examine the association between life-course body silhouette changes and oral conditions in adulthood. METHODS At study recruitment (2008-2012), 5430 adults underwent a full-mouth clinical examination and recalled their body silhouettes at ages 8, 15, 25, 35 and 45. Life-course trajectories of body silhouettes were computed using group-based trajectory modelling. Gingival inflammation, dental plaque, masticatory units, numbers of healthy, missing, decayed and filled teeth at study recruitment were clustered. The associations between body silhouette trajectories and clusters of oral conditions were assessed by multinomial logistic regression. RESULTS The final analysis included 4472 participants. Five body silhouette trajectories were established: lean-stable (30.0%), lean-increased (19.3%), moderate stable (18.1%), lean-marked increased (25.8%) and heavy stable (6.7%). Three clusters of oral conditions were identified: optimal oral health and preserved masticatory capacity (70.0%, cluster 1), moderate oral health and moderately impaired masticatory capacity (25.4%, cluster 2) and poor oral health and severely impaired masticatory capacity (4.7%, cluster 3). Participants with a lean-increased trajectory were 58% more likely than those with a lean-stable trajectory to be in cluster 3 (aOR 1.58 [95% CI 1.07; 2.35]) relative to cluster 1, independently of covariates measured at study recruitment and including age, sex, smoking, socioeconomic status, BMI, hypertension, type 2 diabetes, cholesterol and triglycerides. CONCLUSIONS A life-course lean-increased body silhouette trajectory is associated with higher likelihood of poor oral health and severely impaired masticatory capacity in adulthood.
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Affiliation(s)
- Yara Saade
- Department of Periodontology, Université Paris Cité, Paris, France
- Rothschild Hospital, APHP, Paris, France
| | - Omar Deraz
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Eirini Chatzopoulou
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Hélène Rangé
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
- Department of Periodontology, Service of Odontology, University hospital of Rennes, University of Rennes 1, U.F.R. of Odontology, Paris, France
- INSERM, INRAE, University of Rennes 1 NUMECAN Institute (Nutrition Metabolisms and Cancer), Rennes, France
- FHU PaCeMM Paris Center for Microbiome Medicine, Paris, France
| | - Pierre Boutouyrie
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Marie-Cécile Perier
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Catherine Guibout
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | | | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
| | - Philippe Bouchard
- Department of Periodontology, Université Paris Cité, Paris, France
- UFR Odontologie, URP 2496 Pathologies, Imagerie et Biothérapies Orofaciales et plateforme imagerie du vivant, Université Paris Cité, Paris, France
| | - Jean-Philippe Empana
- Paris Cardiovascular Research Centre (PARCC), INSERM U 970, Integrative Epidemiology of Cardiovascular Disease, Université Paris Cité, Paris, France
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Litwin M. Pathophysiology of primary hypertension in children and adolescents. Pediatr Nephrol 2024; 39:1725-1737. [PMID: 37700113 PMCID: PMC11026201 DOI: 10.1007/s00467-023-06142-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023]
Abstract
The progress in research on the physiology of the cardiovascular system made in the last 100 years allowed for the development of the pathogenesis not only of secondary forms of hypertension but also of primary hypertension. The main determinants of blood pressure are described by the relationship between stroke volume, heart rate, peripheral resistance, and arterial stiffness. The theories developed by Guyton and Folkow describe the importance of the volume factor and total peripheral resistance. However, none of them fully presents the pathogenesis of essential hypertension. The multifactorial model of primary hypertension pathogenesis developed by Irving Page in the 1940s, called Page's mosaic, covers most of the pathophysiological phenomena observed in essential hypertension. The most important pathophysiological phenomena included in Page's mosaic form a network of interconnected "nodes". New discoveries both from experimental and clinical studies made in recent decades have allowed the original Page mosaic to be modified and the addition of new pathophysiological nodes. Most of the clinical studies confirming the validity of the multifactorial pathogenesis of primary hypertension concern adults. However, hypertension develops in childhood and is even perinatally programmed. Therefore, the next nodes in Page's mosaic should be age and perinatal factors. This article presents data from pediatric clinical trials describing the most important pathophysiological processes associated with the development of essential hypertension in children and adolescents.
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Affiliation(s)
- Mieczysław Litwin
- Department of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Warsaw, Poland.
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Zhao F, Zhao Q, Wang H, Wang K, Kong S, Ma P, Wang X. Weight changes from early to middle adulthood and cardiometabolic multimorbidity later in life among middle-aged and older adults: a retrospective cohort study from the NHANES 1999-2018. Front Endocrinol (Lausanne) 2024; 15:1306551. [PMID: 38440787 PMCID: PMC10910024 DOI: 10.3389/fendo.2024.1306551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/29/2024] [Indexed: 03/06/2024] Open
Abstract
Background Weight gain in adulthood can influence the development of diabetes and cardiovascular diseases. It is speculated that weight gain is related to cardiometabolic multimorbility (CMM). This study was designed to examine the relationships between weight changes from early to middle adulthood and the risk of CMM. Methods Data of the National Health and Nutrition Examination Survey (NHANES) 1999-2018 cycles were analyzed in the present study. Weights at age 25 years and 10 years before recruitment were self-reported and were used to define five weight change patterns including stable normal, maximum overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity patterns. Meanwhile, absolute weight changes were classified into five groups: weight loss≥ 2.5 kg, weight change within 2.5 kg, 2.5 kg≤ weight gain < 10.0 kg, 10.0 kg≤ weight gain < 20.0 kg, and weight gain≥ 20.0 kg. CMM was defined as the coexistence of two or three of diabetes, coronary heart disease (CHD), and stroke. Results A total of 25,994 participants were included. Across adulthood, compared to stable normal weight, maximal overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity were consistently associated with increased risks of diabetes, CHD, and CMM. For instance, stable obesity was respectively related to 358.0% (HR: 4.58, 95% CI: 4.57, 4.58), 88.0% (HR: 1.88, 95% CI: 1.88, 1.88), and 292.0% (HR: 3.92, 95% CI: 3.91, 3.92) higher risks of diabetes, CHD, and CMM. Meanwhile, any account of weight loss and gain was linked to higher risks of diabetes, CHD, and CMM than weight change within 2.5 kg. However, participants with maximum overweight had a decreased incidence of stroke (HR: 0.85, 95% CI: 0.85, 0.86), and weight loss ≥ 2.5 kg and weight gain ≥ 2.5 and <20 kg were also related to a lower risk of stroke. J-shaped or U-shaped associations of absolute weight changes with the risks of diabetes, CHD, and CMM were observed. Conclusions Maintaining a stable normal weight can benefit more from the prevention of diabetes, CHD, and CMM. Both weight gain and loss across adulthood were accompanied by increased risks of diabetes, CHD, and CMM.
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Affiliation(s)
| | | | | | | | | | | | - Xin Wang
- Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, China
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5
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Pimenta IT, Griep RH, de Matos SMA, de Fatima Haueisen Sander Diniz M, Moreno AB, de Jesus Mendes da Fonseca M. Body shape trajectories are associated with birth weight, body mass index and sociodemographic conditions in participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): a multiple correspondence analysis. BMC Public Health 2023; 23:1857. [PMID: 37749586 PMCID: PMC10518926 DOI: 10.1186/s12889-023-16779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Evaluating lifelong weight trajectories is challenging due to the high costs of studies that follow individuals from childhood to adulthood. The use of silhouette scales has been a new approach to assess the body shape trajectory across life as a proxy for body weight trajectory. Depending on body shape trajectories, individuals may be more prone to develop diseases in adulthood. Therefore, identifying factors related to them is essential for public health. This study aimed to evaluate body shape trajectories across the lifespan and to verify associations between them, birth weight, body mass index, and sociodemographic conditions in a Brazilian cohort. METHODS This is a cross-sectional analysis conducted with 14,014 participants of first follow-up data collection of Longitudinal Study of Adult Health (ELSA-Brasil). ELSA-Brasil is a multicentric prospective cohort study initiated in 2008 with civil servants of six public institutions in the Northeast, South and Southeast regions of Brazil. We applied a clustering method to longitudinal data to identify body shape trajectories from 5 to 40 years of age and assessed the associations between these trajectories and birth weight, body mass index and sociodemographic conditions (race, education, maternal education and monthly per capita family income) using multiple correspondence analysis. RESULTS We found five body shape trajectories for women and three for men. Low birth weight was associated with a slight to moderate increase in shape. High birth weight was associated with maintaining large body size in both sexes and markedly increased body shape in women. Higher sociodemographic status and white race were associated with marked increases in body shape in men and maintenance of medium body shape in women. CONCLUSIONS The study shows that variables related to worse lifetime weight status (evaluated by anthropometry), such as presence of obesity, are also associated with worse body shape trajectories, as assessed with silhouette scales. Our results suggest that body shape trajectories are a good indicator of body weight trajectories and may be used when cohort studies are not possible.
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Affiliation(s)
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | - Arlinda B Moreno
- National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Bennett JP, Liu YE, Quon BK, Kelly NN, Leong LT, Wong MC, Kennedy SF, Chow DC, Garber AK, Weiss EJ, Heymsfield SB, Shepherd JA. Three-dimensional optical body shape and features improve prediction of metabolic disease risk in a diverse sample of adults. Obesity (Silver Spring) 2022; 30:1589-1598. [PMID: 35894079 PMCID: PMC9333197 DOI: 10.1002/oby.23470] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/05/2022] [Accepted: 04/21/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study examined whether body shape and composition obtained by three-dimensional optical (3DO) scanning improved the prediction of metabolic syndrome (MetS) prevalence compared with BMI and demographics. METHODS A diverse ambulatory adult population underwent whole-body 3DO scanning, blood tests, manual anthropometrics, and blood pressure assessment in the Shape Up! Adults study. MetS prevalence was evaluated based on 2005 National Cholesterol Education Program criteria, and prediction of MetS involved logistic regression to assess (1) BMI, (2) demographics-adjusted BMI, (3) 85 3DO anthropometry and body composition measures, and (4) BMI + 3DO + demographics models. Receiver operating characteristic area under the curve (AUC) values were generated for each predictive model. RESULTS A total of 501 participants (280 female) were recruited, with 87 meeting the criteria for MetS. Compared with the BMI model (AUC = 0.819), inclusion of age, sex, and race increased the AUC to 0.861, and inclusion of 3DO measures further increased the AUC to 0.917. The overall integrated discrimination improvement between the 3DO + demographics and the BMI model was 0.290 (p < 0.0001) with a net reclassification improvement of 0.214 (p < 0.0001). CONCLUSIONS Body shape measures from an accessible 3DO scan, adjusted for demographics, predicted MetS better than demographics and/or BMI alone. Risk classification in this population increased by 29% when using 3DO scanning.
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Affiliation(s)
- Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Yong En Liu
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Brandon K Quon
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Nisa N Kelly
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Lambert T Leong
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Michael C Wong
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
| | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Dominic C Chow
- John A. Burns School of Medicine, University of Hawai'i Manoa, Honolulu, Hawaii, USA
| | - Andrea K Garber
- Division of Adolescent & Young Adult Medicine, University of California, San Francisco, California, USA
| | - Ethan J Weiss
- Division of Cardiology, University of California School of Medicine, San Francisco, California, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - John A Shepherd
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, Hawaii, USA
- Department of Epidemiology, University of Hawai'i Cancer Center, Honolulu, Hawaii, USA
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Abstract
Although relatively rare in childhood, primary hypertension (PH) is thought to have originated in childhood and may be even determined perinatally. PH prevalence increases in school-age children and affects 11% of 18-year-old adolescents. Associated with metabolic risk factors, elevated blood pressure in childhood is carried into adulthood. Analysis of the phenotype of hypertensive children has revealed that PH is a complex of anthropometric and neuro-immuno-metabolic abnormalities, typically found in hypertensive adults. Children with elevated blood pressure have shown signs of accelerated biological development, which are closely associated with further development of PH, metabolic syndrome, and cardiovascular disease in adulthood. At the time of diagnosis, hypertensive children were reported to have significant arterial remodelling expressed as significantly increased carotid intima-media thickness, increased stiffness of large arteries, lower area of microcirculation, and decreased endothelial function. These changes indicate that their biological age is 4 to 5 years older than their normotensive peers. All these abnormalities are typical features of early vascular aging described in adults with PH. However, as these early vascular changes in hypertensive children are closely associated with features of accelerated biological development and neuro-immuno-metabolic abnormalities observed in older subjects, it seems that PH in childhood is not only an early vascular aging event, but also an early biological maturation phenomenon.
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Divo MJ, Marin Oto M, Casanova Macario C, Cabrera Lopez C, de-Torres JP, Marin Trigo JM, Hersh CP, Ezponda Casajús A, Maguire C, Pinto-Plata VM, Polverino F, Ross JC, DeMeo D, Bastarrika G, Silverman EK, Celli BR. Somatotypes trajectories during adulthood and their association with COPD phenotypes. ERJ Open Res 2020; 6:00122-2020. [PMID: 32963991 PMCID: PMC7487345 DOI: 10.1183/23120541.00122-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/15/2020] [Indexed: 11/21/2022] Open
Abstract
RATIONALE Chronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all characterised by airflow limitation. OBJECTIVES We hypothesised that somatotype changes - as a surrogate of adiposity - from early adulthood follow different trajectories to reach distinct phenotypes. METHODS Using the validated Stunkard's Pictogram, 356 COPD patients chose the somatotype that best reflects their current body build and those at ages 18, 30, 40 and 50 years. An unbiased group-based trajectory modelling was used to determine somatotype trajectories. We then compared the current COPD-related clinical and phenotypic characteristics of subjects belonging to each trajectory. MEASUREMENTS AND MAIN RESULTS At 18 years of age, 88% of the participants described having a lean or medium somatotype (estimated body mass index (BMI) between 19 and 23 kg·m-2) while the other 12% a heavier somatotype (estimated BMI between 25 and 27 kg·m-2). From age 18 onwards, five distinct trajectories were observed. Four of them demonstrating a continuous increase in adiposity throughout adulthood with the exception of one, where the initial increase was followed by loss of adiposity after age 40. Patients with this trajectory were primarily females with low BMI and D LCO (diffusing capacity of the lung for carbon monoxide). A persistently lean trajectory was seen in 14% of the cohort. This group had significantly lower forced expiratory volume in 1 s (FEV1), D LCO, more emphysema and a worse BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss of tissue (MOLT) phenotype. CONCLUSIONS COPD patients have distinct somatotype trajectories throughout adulthood. Those with the MOLT phenotype maintain a lean trajectory throughout life. Smoking subjects with this lean phenotype in early adulthood deserve particular attention as they seem to develop more severe COPD.
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Affiliation(s)
- Miguel J. Divo
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Marta Marin Oto
- Pulmonary Dept, Clinica Universidad de Navarra, Pamplona, Spain
| | - Ciro Casanova Macario
- Pulmonary Dept and Research Unit, Hospital Universitario La Candelaria, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
| | - Carlos Cabrera Lopez
- Respiratory Service, Hospital Universitario de Gran Canaria Dr. Negrin, Canary Islands, Spain
| | | | - Jose Maria Marin Trigo
- Respiratory Service, Hospital Universitario Miguel Servet, Zaragoza, Spain
- CIBER Enfermedades Respiratorias, Instituto Investigación Sanitaria, Madrid, Spain
| | - Craig P. Hersh
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Boston, MA, USA
| | | | | | | | - Francesca Polverino
- Asthma and Airway Disease Research Center, University of Arizona, Tucson, NM, USA
| | - James C. Ross
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dawn DeMeo
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Boston, MA, USA
| | - Gorka Bastarrika
- Dept of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
| | - Edwin K. Silverman
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Boston, MA, USA
| | - Bartolome R. Celli
- Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Lambert EA, Esler MD, Schlaich MP, Dixon J, Eikelis N, Lambert GW. Obesity-Associated Organ Damage and Sympathetic Nervous Activity. Hypertension 2019; 73:1150-1159. [DOI: 10.1161/hypertensionaha.118.11676] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Elisabeth A. Lambert
- From the Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia (E.A.L., N.E., G.W.L.)
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.A.L., M.D.E., N.E., G.W.L.)
| | - Murray D. Esler
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.A.L., M.D.E., N.E., G.W.L.)
| | - Markus P. Schlaich
- Dobney Hypertension Centre, School of Medicine–Royal Perth Hospital Unit, University of Western Australia (M.P.S.)
| | - John Dixon
- Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (J.D.)
| | - Nina Eikelis
- From the Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia (E.A.L., N.E., G.W.L.)
| | - Gavin W. Lambert
- From the Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia (E.A.L., N.E., G.W.L.)
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.A.L., M.D.E., N.E., G.W.L.)
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