Key result
Metabolic syndrome and high epicardial fat linked to a ~34% higher LVDD rate in obesity.
Why the study?
LVDD is common in obesity, and this study examined whether activin A links increased EAT, MetS, and LVDD in severely obese subjects.
Is the adipo-fibrokine activin A associated with epicardial fat thickness, metabolic syndrome, and left ventricular diastolic dysfunction in obese patients?
Cross-Sectional
Is the adipo-fibrokine activin A associated with epicardial fat thickness, metabolic syndrome, and left ventricular diastolic dysfunction in obese patients?
Serum activin A is elevated in severe obesity and correlates with epicardial fat thickness, metabolic syndrome, and left ventricular diastolic dysfunction, suggesting a role in obesity-related heart disease.
Answers are grounded in this paper and cite their sources.
May indicate elevated diastolic dysfunction risk in obese patients with metabolic syndrome plus high epicardial fat; leaves open activin A as mediator pending prospective studies.
AIMS: Left ventricular diastolic dysfunction (LVDD) is common in obese subjects, and a relationship between epicardial adipose tissue (EAT), increased adipocytokines, and cardiovascular diseases has been reported. This study sought to examine as to whether the adipo-fibrokine activin A is a link between increased EAT, the metabolic syndrome (MetS), and LVDD in severely obese subjects. METHODS AND RESULTS: ), serum activin A levels were measured and correlated with parameters of the MetS, epicardial fat thickness (EFT), and echocardiographic parameters of LVDD. Activin A levels were higher in obese than in non-obese subjects (362 ± 124 vs. 301 ± 94 pg/mL, P = 0.0004), increased with the number of MetS components (from 285 ± 82 with no MetS component, 323 ± 94 with one or two MetS components, to 403 ± 131 pg/mL with ≥3 MetS components, P < 0.0001) and correlated with EFT (r = 0.41, P < 0.001). Furthermore, activin A levels were related to several parameters of LVDD [e.g. left atrial size (382 ± 117 vs. 352 125 pg/mL, P = 0.024), E/e' (394 ± 108 vs. 356 ± 127 pg/mL, P = 0.005)]. LVDD was highest in MetS obese subjects with high EFT (44.3%) compared with MetS obese subjects with low EFT (27.0%), non-MetS obese subjects with high EFT (24.2%), and non-MetS obese subjects with low EFT (10.6%, P < 0.0001). CONCLUSIONS: In severe obesity, activin A was significantly related to EFT, MetS, and LVDD, implicating MetS-related alterations in the secretory profile of EAT in the pathogenesis of obesity-related heart disease.
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Zeller et al. (2019) conducted a cross-sectional in Severe obesity and metabolic syndrome. Metabolic syndrome and high epicardial fat thickness vs. No metabolic syndrome and low epicardial fat thickness was evaluated on Left ventricular diastolic dysfunction (LVDD) (p=<0.0001). In obese subjects, the combination of metabolic syndrome and high epicardial fat thickness was associated with a 44.3% rate of left ventricular diastolic dysfunction compared to 10.6% in those without.
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