Background

The aim of this study was to determine whether long-term patterns of change in adiposity throughout young adulthood are associated with systolic and diastolic function in midlife.

Methods

Participants in the Coronary Artery Risk Development in Young Adults study, a multicenter, population-based cohort, underwent repeated anthropometric assessment (body mass index [BMI], waist circumference, and waist-to-hip ratio) from examination years 0 to 25. At year 25, longitudinal, circumferential, and radial strain and tissue Doppler velocities were assessed by echocardiography. Group-based trajectory modeling was used to identify 25-year trajectories of change in anthropometric measures and to examine associations between trajectories of adiposity change and indices of cardiac mechanics.

Results

Among 3,310 participants, four distinct trajectories of BMI change were identified: stable BMI (36% of the cohort; mean ΔBMI, 1.6 kg/m²), mild increase (40%; mean ΔBMI, 6.0 kg/m²), moderate increase (18%; mean ΔBMI, 10.8 kg/m²), and major increase (6%; mean ΔBMI, 15.5 kg/m²). Trajectories of greater BMI increase were associated with lower adjusted e′ velocity and higher E/e′ ratio compared with the stable BMI group, independent of year 0 or year 25 BMI. Participants in increasing BMI trajectory groups compared with the stable BMI group had lower absolute longitudinal strain and greater odds of diastolic dysfunction, independent of year 0 BMI but not year 25 BMI. Similar patterns were observed for change in waist circumference and waist-to-hip ratio trajectory groups.

Conclusions

Steeper trajectories of BMI increase from young adulthood to middle age, a vulnerable period for weight gain, are independently associated with lower e′ velocity and higher E/e′ ratio, but not systolic dysfunction, in midlife.

中文翻译：

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从成年早期到中年肥胖变化模式与舒张功能和收缩心肌力学的关联：年轻人研究中的冠状动脉风险发展

 背景

本研究的目的是确定整个青年期肥胖的长期变化模式是否与中年的收缩和舒张功能相关。

 方法

年轻人冠状动脉风险发展研究是一项多中心、以人群为基础的队列，参与者从 0 到 25 年的检查期间接受了重复的人体测量评估（体重指数 [BMI]、腰围和腰臀比）。第 25 年，通过超声心动图评估纵向、周向和径向应变和组织多普勒速度。基于群体的轨迹模型用于确定人体测量指标 25 年的变化轨迹，并检查肥胖变化轨迹与心脏力学指数之间的关联。

 结果

在 3,310 名参与者中，确定了 BMI 变化的四种不同轨迹：BMI 稳定（队列中的 36%；平均 ΔBMI，1.6 kg/m ² ）、轻度增加（40%；平均 ΔBMI，6.0 kg/m ² ）、中度增加（18%；平均 ΔBMI，10.8 kg/m ² ），以及大幅增加（6%；平均 ΔBMI，15.5 kg/m ² ）。与稳定 BMI 组相比，BMI 增加幅度较大的轨迹与较低的调整 e′ 速度和较高的 E/e′ 比相关，与 0 年或 25 年 BMI 无关。与 BMI 稳定组相比，BMI 轨迹增加组的参与者具有较低的绝对纵向应变和较大的舒张功能障碍几率，与 0 年 BMI 无关，但与 25 年 BMI 无关。腰围和腰臀比轨迹组的变化也观察到类似的模式。

 结论

从青年期到中年（体重增加的脆弱时期），BMI 的增长轨迹更陡，与中年时期较低的 e' 速度和较高的 E/e' 比率独立相关，但与收缩功能障碍无关。