Key result
Baseline body fat mass predicted echocardiographic diastolic dysfunction at 5-year follow-up in women (OR 1.059; 95% CI 1.051-1.115; P=0.002), highlighting sex-dependent effects on cardiac health.
Why the study?
Among older adults, sex hormones may exert differential effects on body fat and cardiac health, prompting evaluation of sex-specific effects on body fat composition, aging-related diastolic function, and their longitudinal changes.
Does body fat composition and its longitudinal changes affect cardiac diastolic function and clinical outcomes differently between sexes in community-dwelling older adults?
Cohort (n=409)
Does body fat composition and its longitudinal changes affect cardiac diastolic function and clinical outcomes differently between sexes in community-dwelling older adults?
Baseline and interval increases in body fat quantity are associated with differential trajectories of longitudinal cardiac diastolic functional deterioration between sexes, with body fat mass and waist-hip ratio predicting worse outcomes particularly in women.
Answers are grounded in this paper and cite their sources.
May inform sex-stratified risk assessment in older women; hypothesis-generating and requires prospective validation.
BACKGROUND: Among older adults, sex hormones may exert differential effects on body fat and cardiac health. OBJECTIVES: The authors aimed to study the effects of sex on body fat composition and aging-related diastolic function, as well as their longitudinal changes. METHODS: Community-dwelling older adults without cardiovascular disease underwent prospective baseline same-day anthropometry for body fat mass (BFM), percentage body fat (PBF), and waist hip ratio (WHR) quantification by bioimpedance and transthoracic Doppler echocardiography, with measurements repeated at 5 years. Study outcomes included diastolic grade, ratio of early to late diastolic inflow velocities (E/A), ratio of mitral early diastolic inflow velocity to the average of septal and lateral early diastolic annular tissue velocities (E/e') ratios, left ventricle mass index, left atrial volume index and clinical outcomes. Correlations between baseline or interval changes (Δ) of WHR, BFM and PBF with follow-up or Δ values of outcomes were analyzed, with multivariable linear regression model adjustments for significant variables. RESULTS: Among 409 older adults (mean age 61 ± 12.7 years, 214 women) with median follow-up of 4.9 (4.5, 5.2) years, baseline BFM predicted echocardiographic diastolic dysfunction at follow-up in women (OR: 1.059; 95% CI: 1.051-1.115; P = 0.002). Baseline PBF was associated with ΔE/A (β: 0.010; P = 0.028) among women and ΔE/e' (β: -0.069; P = 0.020) among men, with significant interactions between sex and PBF in predicting ΔE/A (P < 0.05). ΔBFM (β: -0.007; P = 0.05) and ΔPBF (β: -0.005; P = 0.047) were associated with ΔE/A independent of baseline BFM/PBF among women. Baseline (HR: 1.141; 95% CI: 1.027-1.158; P = 0.005) and changes in WHR (HR: 0.857; 95% CI: 0.790-0.931; P < 0.001) predicted cardiovascular outcomes among women. CONCLUSIONS: Baseline and interval increase in fat quantity via bioimpedance defined differential trajectories of longitudinal cardiac functional deteriorations between sexes.
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Jiang et al. (2025) conducted a cohort in Community-dwelling older adults without cardiovascular disease (n=409). Body fat composition (BFM, PBF, WHR) was evaluated on echocardiographic diastolic dysfunction at follow-up in women (OR 1.059, 95% CI 1.051-1.115, p=0.002). Baseline body fat mass predicted echocardiographic diastolic dysfunction at 5-year follow-up in women (OR 1.059; 95% CI 1.051-1.115; P=0.002), highlighting sex-dependent effects on cardiac health.
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