Joshua G Leichman, David Aguilar, Terri M King, Adrian Vlada, Manuel Reyes, Heinrich Taegtmeyer
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Specifically, we examined the effects of plasma free fatty acids and insulin sensitivity on left ventricular function in patients with clinically severe obesity.</p><p><strong>Design: </strong>We measured metabolic and cardiac variables in 64 obese patients [body mass index (BMI; in kg/m(2)) > 35], including 2-D complete echocardiogram with M-mode and tissue Doppler imaging, anthropometric measurements, and analysis of blood chemistries.</p><p><strong>Results: </strong>The median (25th and 75th percentile) age and BMI were 46 y (36, 53 y) and 51.5 (42.5, 56.5), respectively. The prevalence of diabetes, hypertension, and insulin resistance were 38%, 53%, and 90%, respectively. Plasma free fatty acid (FFA) concentrations were elevated in the cohort. No association was observed between insulin sensitivity or anthropometric measurements and left ventricular contractile function. However, FFA concentration was independently associated with diastolic function (r = -0.33, P = 0.01), and 40% of the cohort showed age-adjusted diastolic impairment as measured by tissue Doppler imaging.</p><p><strong>Conclusion: </strong>The negative association between FFA and diastolic function, in the setting of insulin resistance, suggests that excess FFA may exert a lipotoxic effect on the heart.</p>","PeriodicalId":315016,"journal":{"name":"The American journal of clinical nutrition","volume":" ","pages":"336-41"},"PeriodicalIF":0.0000,"publicationDate":"2006-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ajcn/84.1.336","citationCount":"76","resultStr":"{\"title\":\"Association of plasma free fatty acids and left ventricular diastolic function in patients with clinically severe obesity.\",\"authors\":\"Joshua G Leichman, David Aguilar, Terri M King, Adrian Vlada, Manuel Reyes, Heinrich Taegtmeyer\",\"doi\":\"10.1093/ajcn/84.1.336\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Obesity is an important contributor to many cardiovascular risk factors and has been associated with abnormalities in cardiac contractile function. 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引用次数: 76
摘要
背景:肥胖是许多心血管危险因素的重要因素,并与心脏收缩功能异常有关。收缩功能受损的原因尚不完全清楚,可能包括基质供应过剩。目的:我们验证代谢失调可能对心功能产生不利影响的假设。具体来说,我们研究了血浆游离脂肪酸和胰岛素敏感性对临床重度肥胖患者左心室功能的影响。设计:我们测量了64例肥胖患者的代谢和心脏变量[体重指数(BMI;(kg/m(2)) > 35],包括二维全超声心动图m型和组织多普勒成像、人体测量和血液化学分析。结果:年龄和BMI中位数(25和75百分位)分别为46 y (36, 53 y)和51.5 y(42.5, 56.5)。糖尿病、高血压和胰岛素抵抗的患病率分别为38%、53%和90%。血浆游离脂肪酸(FFA)浓度在队列中升高。未观察到胰岛素敏感性或人体测量值与左心室收缩功能之间的关联。然而,FFA浓度与舒张功能独立相关(r = -0.33, P = 0.01),通过组织多普勒成像测量,40%的队列显示年龄调整的舒张功能受损。结论:在胰岛素抵抗的情况下,游离脂肪酸与舒张功能呈负相关,表明过量的游离脂肪酸可能对心脏产生脂肪毒性作用。
Association of plasma free fatty acids and left ventricular diastolic function in patients with clinically severe obesity.
Background: Obesity is an important contributor to many cardiovascular risk factors and has been associated with abnormalities in cardiac contractile function. Causes of impaired contractile function are not fully understood and may include an oversupply of substrates.
Objective: We tested the hypothesis that metabolic dysregulation may adversely influence cardiac function. Specifically, we examined the effects of plasma free fatty acids and insulin sensitivity on left ventricular function in patients with clinically severe obesity.
Design: We measured metabolic and cardiac variables in 64 obese patients [body mass index (BMI; in kg/m(2)) > 35], including 2-D complete echocardiogram with M-mode and tissue Doppler imaging, anthropometric measurements, and analysis of blood chemistries.
Results: The median (25th and 75th percentile) age and BMI were 46 y (36, 53 y) and 51.5 (42.5, 56.5), respectively. The prevalence of diabetes, hypertension, and insulin resistance were 38%, 53%, and 90%, respectively. Plasma free fatty acid (FFA) concentrations were elevated in the cohort. No association was observed between insulin sensitivity or anthropometric measurements and left ventricular contractile function. However, FFA concentration was independently associated with diastolic function (r = -0.33, P = 0.01), and 40% of the cohort showed age-adjusted diastolic impairment as measured by tissue Doppler imaging.
Conclusion: The negative association between FFA and diastolic function, in the setting of insulin resistance, suggests that excess FFA may exert a lipotoxic effect on the heart.