Background
The differences in fat deposition sites exhibit varying degrees of systemic inflammatory response and organ damage, especially in severely obese individuals with excessive visceral fat, which is closely related to an increase in mortality rates related to heart and liver diseases. However, few studies have analysed the differences in heart and liver indicators between groups and their correlation based on abdominal visceral fat area (AVFA) as a grouping condition.
Objective
Clarifying the changes in the heart and liver caused by differences in abdominal visceral fat in severely obese individuals and their correlation can help us prevent heart diseases with higher mortality rates in advance and control the progression of liver injury.
Methods
Sixty-nine severely obese subjects were enrolled, with a study group of forty-one individuals (AVFA ≥ 150 cm2) and a control group of twenty-eight individuals (100 cm2 ≤ AVFA < 150 cm2). The differences and correlations between clinical, laboratory, and magnetic resonance imaging (MRI) indicators of the heart and liver between the two groups were analysed.
Results
In the study group, the proportion of type 2 diabetes mellitus (T2DM) and insulin resistance level were higher, and liver function indicators were worse. The left ventricular eccentricity ratio (LVER), left ventricular mass (LVM) and global myocardial wall thickness (GPWT) in the study group were higher than those in the control group (P = 0.002, P = 0.001, P = 0.03), and the left ventricle global longitudinal strain (LVGLS) was lower than that in the control group (P = 0.016). Pericardiac adipose tissue volume (PATV) and myocardial proton density fat fraction (M-PDFF) were higher than those in the control group (P = 0.001, P = 0.001). The hepatic proton density fat fraction (H-PDFF) and abdominal subcutaneous fat area (ASFA) were higher than those in the control group (P < 0.001, P = 0.012). There was a moderate positive correlation (ρ = 0.39 ~ 0.59, P < 0.001) between AVFA and LVER, LVM, GPWT, LVGLS, and H-PDFF. There was no difference in right ventricular and most left ventricular systolic and diastolic function between the two groups.
Conclusion
The high AVFA group had a larger LVM, GPWT and PATV, more obvious changes in LVER, impaired left ventricular diastolic function, an increased risk of heart disease, and more severe hepatic fat deposition and liver injury. Therefore, reducing AVFA in severely obese individuals is beneficial for the heart and liver.