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Associations of childhood and adult obesity with left ventricular structure and function

Abstract

Background:

Overweight and obesity are associated with left ventricular (LV) dysfunction. We sought whether echocardiographic evidence of abnormal adult cardiac structure and function was related to childhood or adult adiposity.

Methods:

This study included 159 healthy individuals aged 7–15 years and followed until age 36–45 years. Anthropometric measurements were performed both at baseline and follow-up. Cardiac structure (indexed left atrial volume (LAVi), left ventricular mass (LVMi)) and LV function (global longitudinal strain (GLS), mitral e′) were assessed using standard echocardiography at follow-up. Conventional cutoffs were used to define abnormal LAVi, LVMi, GLS and mitral annular e′.

Results:

Childhood body mass index (BMI) was correlated with LVMi (r=0.25, P=0.002), and child waist circumference was correlated with LVMi (r=0.18, P=0.03) and LAVi (r=0.20, P=0.01), but neither were correlated with GLS. One s.d. (by age and sex) increase in childhood BMI was associated with LV hypertrophy (relative risk: 2.04 (95% confidence interval (CI): 1.09, 3.78)) and LA enlargement (relative risk: 1.81 (95% CI: 1.02, 3.21)) independent of adult BMI, but the association was not observed with impaired GLS or mitral e′. Cardiac functional measures were more impaired in those who had normal BMI as child, but had high BMI in adulthood (P<0.03), and not different in those who were overweight or obese as a child and remained so in adulthood (P>0.33).

Conclusions:

Childhood adiposity is independently associated with structural cardiac disturbances (LVMi and LAVi). However, functional alterations (GLS and mitral e′) were more frequently associated with adult overweight or obesity, independent of childhood adiposity.

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Acknowledgements

The CDAH study was funded by the Australian National Health and Medical Research Council, the Australian National Heart Foundation, the Tasmanian Community Fund and Veolia Environmental Services, and the contributions of the CDAH’s project manager, Marita Dalton, all other project staff and volunteers, and the study participants. HY is supported by a Health Professional Scholarship from the National Heart Foundation of Australia (100307).

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Correspondence to T H Marwick.

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Yang, H., Huynh, Q., Venn, A. et al. Associations of childhood and adult obesity with left ventricular structure and function. Int J Obes 41, 560–568 (2017). https://doi.org/10.1038/ijo.2016.234

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