Obesity phenotype and cardiovascular changes

• Published in: Journal of hypertension Vol. 29; no. 9; pp. 1765 - 1772
• Main Authors: Park, Juri, Kim, Seong H, Cho, Goo-Yeong, Baik, Inkyung, Kim, Nan H, Lim, Hong E, Kim, Eung J, Park, Chang G, Lim, Sang Y, Kim, Yong H, Kim, Hyun, Lee, Seung K, Shin, Chol
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-09-2011; Lippincott Williams & Wilkins
• Subjects: Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Body Mass Index; Cardiology. Vascular system; Cardiovascular Diseases - physiopathology; Cohort Studies; Female; Humans; Male; Medical sciences; Metabolic diseases; Multivariate Analysis; Obesity; Obesity - physiopathology; Phenotype; Hypertension; arterial stiffness; Obesity; Echocardiography; Nutrition disorder; Cardiovascular disease; carotid intima-media thickness; Left ventricle; metabolic syndrome; Phenotype; Carotid; Stiffness; Nutritional status
• DOI: 10.1097/HJH.0b013e32834a50f3
• EISSN: 1473-5598
• ISSN: 0263-6352

OBJECTIVEHealthy obese phenotype with favorable metabolic profiles is proposed. However, whether healthy obesity leads to target organ changes is controversial. We investigated the impact of a healthy obesity on cardiovascular structure and function.
METHODSA total of 2540 participants without known cardiovascular disease were enrolled. According to BMI and the metabolic syndrome (MetS) component, the participants were divided into six groupshealthy (none of five MetS components) normal weight (BMI <23 kg/m), unhealthy (one or more of five MetS components) normal weight, healthy overweight (BMI 23–24.9 kg/m), unhealthy overweight, healthy obesity (BMI ≥25 kg/m), and unhealthy obesity. The cardiovascular changes were assessed by echocardiography, tissue Doppler imaging (TDI), carotid ultrasonography, and pulse wave velocity (PWV).
RESULTSIn a multivariate analysis after adjusting for age, sex, heart rate, high-sensitivity C-reactive protein, and medication for hypertension and diabetes mellitus, the unhealthy overweight and obese groups showed statistically significant changes in the left ventricular mass index, mitral E/A ratio, E/Ea ratio, TDI Ea velocity, common carotid artery intima–media thickness (CCA-IMT), and brachial-ankle PWV (P < 0.001), compared with the healthy normal weight individuals. In the healthy overweight and obese groups, CCA-IMT and brachial-ankle PWV values were similar, but left-ventricular mass index and TDI Ea velocity were significantly different (P < 0.001).
CONCLUSIONHealthy obesity was associated with subtle changes in left ventricular structure and function. These data provide evidence that metabolically healthy phenotypes with excess weight may not be a benign condition.