Fat Mass is Associated with Subclinical Left Ventricular Systolic Dysfunction in Patients with Type 2 Diabetes Mellitus Without Established Cardiovascular Diseases

Abstract

Introduction Left ventricular global longitudinal strain (GLS) is considered to be the first marker of diabetes mellitus-related subclinical cardiac dysfunction, but whether it is attributable to fat mass and distribution remains uncertain. In this study, we explored whether fat mass, especially fat mass in the android area, is associated with subclinical systolic dysfunction before the onset of cardiac disease. Methods We conducted a single-center prospective cross-sectional study between November 2021 and August 2022 on inpatients of the Department of Endocrinology, Nanjing Drum Tower Hospital. We included 150 patients aged 18–70 years with no signs, symptoms, or history of clinical cardiac disease. Patients were evaluated with speckle tracking echocardiography and dual energy X-ray absorptiometry. The cutoff values for subclinical systolic dysfunction were set at a global longitudinal strain (GLS) < 18%. Results After adjusting for sex and age, patients with GLS < 18% had a higher mean (± standard deviation) fat mass index (8.06 ± 2.39 vs. 7.10 ± 2.09 kg/m 2 , p = 0.02), higher mean trunk fat mass (14.9 ± 4.9 vs. 12.8 ± 4.3 kg, p = 0.01), and higher android fat mass (2.57 ± 1.02 vs. 2.18 ± 0.86 kg, p = 0.02) than those in the GLS ≥ 18%. Partial correlation analysis showed that the fat mass index, truck fat mass, and android fat mass were negatively correlated with GLS after adjusting for sex and age (all p < 0.05). Adjusted for traditional cardiovascular metabolic factors, fat mass index (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.05–1.55, p = 0.02), trunk fat mass (OR 1.13, 95% CI 1.03–1.24, p = 0.01), and android fat mass (OR 1.77, 95% CI 1.16–2.82, p = 0.01) were independent risk factors for GLS < 18%. Conclusion Among patients with type 2 diabetes mellitus without established clinical cardiac disease, fat mass, especially android fat mass, was associated with subclinical systolic dysfunction independently of age and sex. Supplementary Information The online version contains supplementary material available at 10.1007/s13300-023-01411-7.

Exercise‐induced changes in left ventricular strain are affected by interleukin‐6 activity: An exploratory analysis of a randomised‐controlled trial in humans with abdominal obesity

“…Apart from the increase in LV mass, it is unknown whether IL‐6 is also involved in functional cardiac adaptations to exercise training. The existence of such a link is supported by the involvement of IL‐6 in regulating changes in response to exercise training in mass of visceral and epicardial adipose tissue (Christensen, Lehrskov, et al., 2019 ), both of which are fat depots associated with reduced systolic and diastolic dysfunction (Christensen, Hansen, et al., 2019 ; Liu et al., 2023 ). Epicardial adipose tissue (EAT) has in particular, due to its anatomical proximity and metabolic hyperactivity, been proposed to impact cardiac function by secreting inflammatory factors and applying mechanical stress on the myocardium (Christensen, Hansen, et al., 2019 ).…”