Visceral adiposity and skeletal muscle mass are independently and synergistically associated with left ventricular structure and function: the Korean Genome and Epidemiology Study.
BACKGROUND
Obesity and low muscle mass may coexist as age-related changes in body composition. We aimed to investigate the effect of visceral adiposity and skeletal muscle mass on left ventricular (LV) structure and function in the general population.


METHODS
A total of 1941 participants without known cardiovascular disease were enrolled from the Korean Genome and Epidemiology Study. Visceral fat area (VFA) was assessed by computed tomography. Appendicular skeletal muscle mass (ASM) was estimated by dual-energy X-ray absorptiometry and was used as a percentage of body weight (ASM/Wt). LV structure and function were assessed by tissue Doppler imaging (TDI) echocardiography.


RESULTS
Across VFA tertiles, ASM increased, but ASM/Wt decreased (all P<0.001). In multivariate models adjusted for conventional cardiovascular risk factors, LV mass index and LV diastolic parameters, such as left atrial dimension, TDI Ea velocity, and E/Ea ratio, were significantly impaired as VFA increased. On the other hand, an increase in ASM/Wt was associated with a decrease in LV mass index and improvement of LV diastolic parameters. With regard to LV mass index and TDI Ea velocity, VFA and ASM/Wt showed synergistic effects (all P interaction<0.05). When both VFA and ASM/Wt were simultaneously included in the same model, both remained independent predictors of LV mass index and TDI Ea velocity.


CONCLUSIONS
More visceral fat and less muscle mass are independently and synergistically associated with an increase in LV mass index and impairment of LV diastolic parameters. Further research is needed to explore the complex mechanisms underlying these associations.
['Park|Juri|J|', 'Kim|Nan Hee|NH|', 'Kim|Seong Hwan|SH|', 'Kim|Jin-Seok|JS|', 'Kim|Yong Hyun|YH|', 'Lim|Hong Euy|HE|', 'Kim|Eung Ju|EJ|', 'Na|Jin Oh|JO|', 'Cho|Goo-Yeong|GY|', 'Baik|Inkyung|I|', 'Kim|Doo Man|DM|', 'Choi|Dong Seop|DS|', 'Lee|Seung Ku|SK|', 'Shin|Chol|C|']
D050154:Adiposity D000368:Aged D015992:Body Mass Index D015331:Cohort Studies D015150:Echocardiography, Doppler D005260:Female D006352:Heart Ventricles D006801:Humans D050152:Intra-Abdominal Fat D008297:Male D008875:Middle Aged D018482:Muscle, Skeletal D056910:Republic of Korea D012307:Risk Factors D016277:Ventricular Function, Left
Visceral adiposity Skeletal muscle mass Epidemiology Echocardiography Diastole Left ventricular mass