DXA-measured truncal adiposity in adolescence but not in childhood longitudinally predicts worsening cardiac outcomes
Key result
Increasing fat mass from adolescence to young adulthood linked to greater LV mass.
- β = 0.12 g/m2.7
- 95% CI 0.09-0.15
- P<0.001
- n=1,803
Why the study?
Longitudinal evidence linking dual-energy X-ray absorptiometry measures of body composition from childhood with changes in cardiac structure and function in youth is scarce.
Does increased total and trunk fat mass from childhood to young adulthood predict progressive cardiac remodeling?
Key Points
- The aim is to investigate the association between trunk fat mass increase during adolescence and cardiac remodeling into young adulthood.
- Utilized data from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.
- Included 1803 children with DXA measurements of fat mass at ages 9, 11, 15, 17, and 24.
- Performed echocardiography to assess left ventricular mass at ages 17 and 24.
- Analyzed the relationship between fat mass, systolic blood pressure, and inflammation.
- Increased total and trunk fat mass from ages 9-24 was linked to decreased left ventricular mass over 7 years.
- In contrast, fat mass gains from ages 17-24 were associated with increased left ventricular mass.
- Lean mass and body mass index also predicted increased left ventricular mass.
- Systolic blood pressure and high-sensitivity C-reactive protein partly mediated the fat mass and cardiac mass relationship.
Study Design
Type
Cohort (n=1,803)
Structured PICO
Does increased total and trunk fat mass from childhood to young adulthood predict progressive cardiac remodeling?
P
Population
1803 children aged 9 years from the UK birth cohort (ALSPAC) with repeated DXA-measured fat mass at ages 9, 11, 15, 17, and 24 years.
I
Intervention
Increase in total and trunk fat mass measured by dual-energy X-ray absorptiometry (DXA) from childhood to young adulthood.
O
Outcome
Left ventricular mass indexed for height2.7 (LVM) assessed by echocardiography at 17 and 24 years.surrogate
Main Result
Effect estimate: β = 0.12 g/m2.7 (95% CI 0.09-0.15)
p-value: p=<0.001
Increased total and trunk fat mass from adolescence, but not from childhood, predicts progressive cardiac structural remodeling by young adulthood, partially mediated by systolic blood pressure and inflammation.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Fat mass drives insulin resistance, but muscle mass appears to reverse it in a very small way. If we only use BMI, we will not be able to see that muscle mass is beneficial in lowering insulin resistance. …abdominal fat is twice as dangerous as total body fat. Every increase in abdominal fat raised the risk of insulin resistance, not just at the time point but progressively from age 15 to 24.”
“This is the first long-term evidence of the morbid danger of high total body and abdominal fat in the young population, with abdominal fat twice as dangerous as total body fat. To observe a vicious cycle of fat mass and insulin resistance between the ages of 17 and 24 years is extremely disheartening. Fat mass contributes 75-percent to the fat mass-insulin resistance vicious cycle, while insulin resistance contributes 25-percent. Therefore, preventing weight gain is the best way to break this cycle.”
Implication
May support adolescent obesity prevention to limit future left ventricular remodeling; extends adult data but remains hypothesis-generating pending trials.
Abstract
Background Longitudinal evidence on the dual-energy X-ray absorptiometry measures of body composition from childhood with changes in cardiac structure and function in youth is scarce. Objectives This study examined whether the increase in total and trunk fat mass during growth from childhood is associated with progressive cardiac remodeling and whether increased systolic blood pressure and inflammation explained the associations. Methods From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 1803 children aged 9 years who had repeated dual-energy X-ray absorptiometry-measured fat mass at ages, 9, 11, 15, and 17 and 24 years clinic visits were included. Echocardiography at 17 and 24 years assessed left ventricular mass indexed for height2.7 (LVM). Results Each unit increase of total fat mass from age 9-24 years (β = −0.48 g/m2.7 [95% CI, −0.50-−0.48], P < .001) and trunk fat mass (−0.78 g/m2.7 [−0.83 to −0.74], P < .001) were independently associated with progressively decreased LVM over 7 years. However, each unit increase of total fat mass from age 17-24 years (β = 0.12 g/m2.7 [95% CI, 0.09-0.15], P < .001) and trunk fat mass (0.23 g/m2.7 [0.18-0.28], P < .001) were independently associated with increased LVM. Each unit increase of lean mass from age 9-24 years (β = 0.31 g/m2.7 [95% CI, 0.29-0.33], P < .001) and body mass index (0.24 g/m2.7 [0.20-0.27], P < .001) were independently associated with increased LVM. Increased systolic blood pressure and high-sensitivity C-reactive protein partly mediated (10.6% and 7.4% mediation, respectively), the association between increased fat mass and increased cardiac mass during growth from adolescence to young adulthood. Conclusions Increased total and trunk fat mass from adolescence but not from childhood predicted progressive cardiac structural and functional pathologies by young adulthood.
Discussion
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Figures from the paper
Published by European Journal of Endocrinology · CC BYCite This Study
Andrew O. Agbaje (2026) reported a cohort. Total and trunk fat mass was evaluated on Left ventricular mass indexed for height2.7 (LVM) (β = 0.12 g/m2.7, 95% CI 0.09-0.15, p=<0.001). Increased total fat mass from adolescence to young adulthood (age 17-24 years) was independently associated with increased left ventricular mass (β = 0.12 g/m2.7; 95% CI, 0.09-0.15; P<0.001).