Title | Weight History and Subclinical Myocardial Damage. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Ndumele CE, Cobb L, Lazo M, Bello NA, Shah A, Nambi V, Blumenthal RS, Gerstenblith G, Solomon SD, Ballantyne CM, Selvin E |
Secondary Authors | Coresh JJ |
Journal | Clin Chem |
Volume | 64 |
Issue | 1 |
Pagination | 201-209 |
Date Published | 2018 01 |
ISSN | 1530-8561 |
Keywords | Adult, Atherosclerosis, Body Mass Index, Female, Heart Failure, Humans, Male, Middle Aged, Myocardium, Obesity, Troponin T |
Abstract | BACKGROUND: Excess weight is associated with subclinical myocardial damage, as reflected by high-sensitivity cardiac troponin T (hs-cTnT) concentrations, which portends high heart failure risk. However, the association between weight history and myocardial damage is unknown. METHODS: We evaluated 9062 Atherosclerosis Risk in Communities (ARIC) visit 4 (1996-1999) participants with a body mass index (BMI) ≥ 18.5 kg/m and no previous cardiovascular disease. We cross-tabulated visit 4 ("current") BMI categories of normal weight, overweight, and obese with those at visit 1 (1987-1989) and with BMI categories calculated from self-reported weight at age 25 years. Duration of obesity was calculated in years. A cumulative weight measure of "excess BMI-years" was also calculated [product of mean BMI (centered at 25 kg/m) over all ARIC time points × follow-up duration]. We used logistic regression to estimate associations of weight history metrics with increased hs-cTnT (≥14 ng/L) at visit 4. RESULTS: Overall, 623 individuals (7%) had increased hs-cTnT at visit 4. Within each current BMI category, previous excess weight was associated with increased hs-cTnT, with the strongest associations for those with past and current obesity [odds ratio (OR), 3.85; 95% CI, 2.51-5.90 for obesity at age 25 years and visit 4]. Each 10-year longer obesity duration was associated with increased hs-cTnT (OR, 1.26; 95% CI, 1.17-1.35). Each 100 higher excess BMI-years was also progressively associated with increased hs-cTnT (OR, 1.21; 95% CI, 1.14-1.27). CONCLUSIONS: Previous obesity and greater cumulative weight from young adulthood increase the likelihood of myocardial damage, indicating long-term toxic effects of adiposity on the myocardium and the need for weight maintenance strategies targeting the entire life span. |
DOI | 10.1373/clinchem.2017.282798 |
Alternate Journal | Clin Chem |
PubMed ID | 29158254 |
PubMed Central ID | PMC6219376 |
Grant List | K23 HL122447 / HL / NHLBI NIH HHS / United States R01 DK089174 / DK / NIDDK NIH HHS / United States KL2 TR001874 / TR / NCATS NIH HHS / United States HHSN268201700001I / HL / NHLBI NIH HHS / United States K24 DK106414 / DK / NIDDK NIH HHS / United States HHSN268201700004I / HL / NHLBI NIH HHS / United States HHSN268201000021C / HL / NHLBI NIH HHS / United States HHSN268201700002I / HL / NHLBI NIH HHS / United States HHSN268201700005I / HL / NHLBI NIH HHS / United States UL1 TR001873 / TR / NCATS NIH HHS / United States HHSN268201700003I / HL / NHLBI NIH HHS / United States |