Abstract
Intro: People with obesity who are metabolically healthy (MHO) have lower CVD and HF incidence compared to those with obesity and unhealthy metabolic risk factors (MOU), but higher risk than those with normal weight and metabolic healthy profiles (MHNW). However, it is unclear whether there are differences in left ventricle (LV) cardiovascular functioning/structure associated with early-stage HF (i.e., preclinical HF) risk among various metabolic health-body mass phenotypes within the Hispanic/Latino population. Therefore, the current study assessed preclinical HF risk in persons classified as Metabolically Healthy Overweight/Obese (MH-OW/OB) compared with MUO and MHNW, who were enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and ancillary Echocardiographic Study of Latinos (ECHO-SOL).
Methods: Data were derived from the HCHS/SOL&ECHO-SOL visit 2 (n = 2082, M age = 54.5 years old, 51.2% women). Metabolic health was defined as having none of the following: elevated fasting glucose, triglycerides, blood pressure, insulin resistance, low HDL cholesterol and or use of medication for any of the elevated criteria (e.g., hypertension medication). Body Mass was assessed via BMI categories. Preclinical HF was defined as evidence of LV diastolic/systolic dysfunction and or LV hypertrophy measured via echocardiography. Weighted logistic regression assessed preclinical HF risk between MH-OW/OB vs MUO, and MH-OW/OB vs MHNW while controlling age, sex, field center, heritage, years living in US, and time since last visit (years between visit 1 and visit 2). Study design features were incorporated in planned logistic regression analyses.
Results: Of the population, 329.1 were MH-OW/OB, 1088.1 were MUO, and 154.1 were MHNW (weighted counts). Weighted logistic regression analyses indicated that MH-OW/OB had lower risk of preclinical HF compared with MUO persons [Odds Ratio (OR): 0.25, 95% CI: 0.12-0.54]. Notably, MH-OW/OB persons were not significantly different in preclinical HF risk compared with MHNW persons [OR: 1.90, 95% CI: 0.58-6.22].
Conclusion: Results suggest that the MH-OW/OB classification may not confer added risk of preclinical HF compared to MHNW. However, findings indicate that MH-OW/OB has lower preclinical HF risk compared with MUO. Additional research is needed to determine if changes in cardiac structure/function are linked with adipocyte physiology that may underlie HF pathophysiology within the Hispanic/Latino population.