Effect of Overweight and Obesity (Defined by Asian-Specific Cutoff Criteria) on Left Ventricular Diastolic Function and Structure in a General Korean Population

Abstract

Background:Although obesity is a well-known risk factor for cardiovascular disease, the cutoff of body mass index (BMI) for elevated cardiovascular risk is still controversial in Asian. Thus, this study was conducted to investigate the functional and structural changes of the left ventricle (LV) according to the degree of obesity in a general Korean population.

Methods and Results:A total of 31,334 apparently healthy Korean adults who underwent echocardiography were enrolled. The study population was stratified into 5 groups according to the degree of obesity classified by the Asian-Pacific obesity guideline. The odd ratios (ORs) with 95% confidence interval (CI) of impaired LV diastolic function, LV remodeling, and hypertrophy were compared among the 5 groups using multivariable logistic regression analysis. When the normal group was set as the reference, the adjusted ORs (95% CI) for impaired LV diastolic function showed a proportional relationship with BMI [OR; 0.86 (95% CI 0.59–1.22) in underweight, 1.81 (95% CI 1.63–2.00) in overweight, 2.75 (95% CI 2.49–3.03) in obese, and 4.34 (95% CI 3.65–5.16) in severe obese]. Adjusted ORs for LV remodeling and hypertrophy significantly increased proportional to BMI.

Conclusions:Even with strict classification of obesity by the Asian-Pacific guideline, BMI of more than overweight (≥23 kg/m²) was significantly associated with impaired LV diastolic function, remodeling, and hypertrophy.