Visceral obesity, but not central obesity, is associated with cardiac remodeling in subjects with suspected metabolic syndrome

Abstract

Background and aims: Metabolic syndrome (MetS) is a cluster of multiple risk factors including central obesity that may lead to cardiac damage and cardiovascular events. We investigated whether visceral obesity induces cardiac structural and functional remodeling independently from central obesity and other risk factors in subjects with suspected MetS.

Methods and results: We studied 229 participants with suspected MetS. Visceral fat area (VFA) was measured by bioelectrical impedance analysis. Left ventricular (LV) mass index, early diastolic velocity of mitral annulus (e'), and LV global longitudinal strain (GLS) were measured by echocardiography. Subjects were categorized into high and low VFA group (VFA_h and VFA_l). MetS was more prevalent in the VFA_h than in the VFA_l (p = 0.004). The VFA_h had a higher waist circumference (WC) than the VFA_l (p < 0.001). LV mass index was higher, but e' and GLS were lower in the VFA_h than in VFA_l (all p < 0.05). VFA was well correlated with blood pressure, fasting blood glucose, triglyceride, high-sensitivity C-reactive protein and adiponectin (all p < 0.05). VFA was correlated to LV mass index, e', and GLS (all p < 0.05) and was independently associated with GLS after adjustment for other risk factors, including WC (p = 0.005).

Conclusions: Visceral obesity assessed by VFA was well correlated with parameters of MetS. Visceral obesity, but not central obesity measured by WC, was independently associated with structural and functional cardiac remodeling in subjects with suspected MetS. It suggests that visceral obesity should be considered as an important risk factor for cardiac damage in dysmetabolic subjects.

Trial registration: NCT02077530 (date of registration: November 1, 2013).

Keywords: Cardiovascular disease; Metabolic syndrome; Visceral fat; Visceral obesity.