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Cai Z, Chen G, Zhao W, Wei Z, Wang X, Huang Z, Zheng H, Wu K, Liu Y, Lan Y, Wu W, Wu S, Chen Y. Increased Risk of Cardiometabolic Disease in Ideal Weight Adults With History of Overweight/Obesity in China: A Prospective Cohort Study. J Am Heart Assoc 2024; 13:e033610. [PMID: 38700033 PMCID: PMC11179937 DOI: 10.1161/jaha.123.033610] [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: 11/19/2023] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Overweight and obesity represent critical modifiable determinants in the prevention of cardiometabolic disease (CMD). However, the long-term impact of prior overweight/obesity on the risk of CMD in later life remains unclear. We aimed to investigate the association between longitudinal transition of body mass index (BMI) status and incident CMD. METHODS AND RESULTS This prospective cohort study included 57 493 CMD-free Chinese adults from the Kailuan Study. BMI change patterns were categorized according to the BMI measurements obtained during the 2006 and 2012 surveys. The primary end point was a composite of myocardial infarction, stroke, and type 2 diabetes. Cox regression models were used to evaluate the associations of transitions in BMI with overall CMD events and subtypes, with covariates selected on the basis of the directed acyclic graph. During a median follow-up of 7.62 years, 8412 participants developed CMD. After considering potential confounders, weight gain pattern (hazard ratio [HR], 1.34 [95% CI, 1.23-1.46]), stable overweight/obesity (HR, 2.12 [95% CI, 2.00-2.24]), and past overweight/obesity (HR, 1.73 [95% CI, 1.59-1.89]) were associated with the incidence of CMD. Similar results were observed in cardiometabolic multimorbidity, cardiovascular disease, and type 2 diabetes. Additionally, triglyceride and systolic blood pressure explained 8.05% (95% CI, 5.87-10.22) and 12.10% (95% CI, 9.19-15.02) of the association between past overweight/obesity and incident CMD, respectively. CONCLUSIONS A history of overweight/obesity was associated with an increased risk of CMD, even in the absence of current BMI abnormalities. These findings emphasize the necessity for future public health guidelines to include preventive interventions for CMD in individuals with past overweight/obesity.
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Affiliation(s)
- Zhiwei Cai
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
- Shantou University Medical College Shantou China
| | - Guanlin Chen
- Second Clinical College China Medical University Shenyang China
| | - Wenliu Zhao
- School of Public Health North China University of Science and Technology Tangshan China
| | - Zhihao Wei
- School of Public Health North China University of Science and Technology Tangshan China
| | - Xianxuan Wang
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
| | - Zegui Huang
- Department of Cardiology Sun Yat-sen Memorial Hospital of Sun Yat-sen University Guangzhou China
| | - Huancong Zheng
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
- Shantou University Medical College Shantou China
| | - Kuangyi Wu
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
- Shantou University Medical College Shantou China
| | - Yang Liu
- Department of Biostatistics and Epidemiology School of Public Health China Medical University Shenyang China
| | - Yulong Lan
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
| | - Weiqiang Wu
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
| | - Shouling Wu
- Department of Cardiology Kailuan General Hospital Tangshan China
| | - Youren Chen
- Department of Cardiology Second Affiliated Hospital of Shantou University Medical College Shantou China
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Liu J, Yang F, Sun Q, Gu T, Yao J, Zhang N, Meng R, Zhu D. Fat Mass is Associated with Subclinical Left Ventricular Systolic Dysfunction in Patients with Type 2 Diabetes Mellitus Without Established Cardiovascular Diseases. Diabetes Ther 2023; 14:1037-1055. [PMID: 37140878 DOI: 10.1007/s13300-023-01411-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Left ventricular global longitudinal strain (GLS) is considered to be the first marker of diabetes mellitus-related subclinical cardiac dysfunction, but whether it is attributable to fat mass and distribution remains uncertain. In this study, we explored whether fat mass, especially fat mass in the android area, is associated with subclinical systolic dysfunction before the onset of cardiac disease. METHODS We conducted a single-center prospective cross-sectional study between November 2021 and August 2022 on inpatients of the Department of Endocrinology, Nanjing Drum Tower Hospital. We included 150 patients aged 18-70 years with no signs, symptoms, or history of clinical cardiac disease. Patients were evaluated with speckle tracking echocardiography and dual energy X-ray absorptiometry. The cutoff values for subclinical systolic dysfunction were set at a global longitudinal strain (GLS) < 18%. RESULTS After adjusting for sex and age, patients with GLS < 18% had a higher mean (± standard deviation) fat mass index (8.06 ± 2.39 vs. 7.10 ± 2.09 kg/m2, p = 0.02), higher mean trunk fat mass (14.9 ± 4.9 vs. 12.8 ± 4.3 kg, p = 0.01), and higher android fat mass (2.57 ± 1.02 vs. 2.18 ± 0.86 kg, p = 0.02) than those in the GLS ≥ 18%. Partial correlation analysis showed that the fat mass index, truck fat mass, and android fat mass were negatively correlated with GLS after adjusting for sex and age (all p < 0.05). Adjusted for traditional cardiovascular metabolic factors, fat mass index (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.05-1.55, p = 0.02), trunk fat mass (OR 1.13, 95% CI 1.03-1.24, p = 0.01), and android fat mass (OR 1.77, 95% CI 1.16-2.82, p = 0.01) were independent risk factors for GLS < 18%. CONCLUSION Among patients with type 2 diabetes mellitus without established clinical cardiac disease, fat mass, especially android fat mass, was associated with subclinical systolic dysfunction independently of age and sex.
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Affiliation(s)
- Jie Liu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210008, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Fan Yang
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Qichao Sun
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210008, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Tianwei Gu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Jing Yao
- Department of Ultrasound Medicine, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, 210008, China
| | - Ning Zhang
- Department of Ultrasound Medicine, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, 210008, China.
| | - Ran Meng
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210008, China.
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
| | - Dalong Zhu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, 210008, China.
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
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Bhadada SK, Malhotra B, Shetty AJ. Body Weight Variability and Cardiovascular Health in Diabetes. J Clin Endocrinol Metab 2023; 108:e19-e20. [PMID: 36317543 DOI: 10.1210/clinem/dgac629] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/20/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Sanjay Kumar Bhadada
- Department of Endocrinology and Metabolism, Post Graduate Institute of Medical Education and Research, PGIMER, Nehru Extension, Chandigarh, 160011, India
| | - Bhanu Malhotra
- Department of Endocrinology and Metabolism, Post Graduate Institute of Medical Education and Research, PGIMER, Nehru Extension, Chandigarh, 160011, India
| | - Anirudh J Shetty
- Department of Endocrinology and Metabolism, Post Graduate Institute of Medical Education and Research, PGIMER, Nehru Extension, Chandigarh, 160011, India
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