Body Fat Distribution, Fat-Free Mass and Cardiovascular Function in the UK Biobank

Background We evaluated the independent associations of body composition measures on left ventricular ejection fraction (LVEF) and pulse wave arterial stiffness index (PWASI). Methods The present analysis included 23,258 individuals (mean age 63 years, 53% women) who participated in the whole body imaging sub-study of the UK Biobank. Associations of body composition measures with each of LVEF and PWASI, after mutual adjustment for one another and potential confounders, were determined using multivariable linear regression. Results Among regional body fat measures, higher visceral fat (VAT) was associated with lower LVEF ( β = − 0.45; 95% CI − 0.60, − 0.31 per SD) and higher PWASI ( β = 0.51; 95% CI 0.38–0.65 per SD). The association between VAT and LVEF was negatively linear but positively linear for PWASI throughout the range of VAT measured. Other regional fat measures and fat-free mass were not significantly associated with either LVEF or PWASI. Central adiposity measures (waist circumference [WC] and waist–hip ratio [WHR]) showed significant inverse association with LVEF (WC: β = − 0.11; 95% CI − 0.21, − 0.01 per SD; WHR β = − 0.25; 95% CI − 0.38, − 0.12 per SD) but positive association with PWASI (WC: β = 0.37; 95% CI 0.28–0.47 per SD; WHR β = 0.39; 95% CI 0.27 − 0.51 per SD) while BMI was not significantly associated with LVEF ( β = 0.05; 95% CI − 0.04, 0.14 per SD) but showed weaker positive association with PWASI ( β = 0.27; 95% CI 0.18–0.35 per SD). Conclusions Excess visceral fat and central adiposity are associated with impaired LV function and increased arterial stiffness which may predispose to heart failure.