Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults
Background: Among older adults, sex hormones may exert differential effects on body fat and cardiac health. Objectives: The authors aimed to study the effects of sex on body fat composition and aging-related diastolic function, as well as their longitudinal changes. Methods: Community-dwelling older...
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Elsevier
2025-09-01
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| Series: | JACC: Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772963X25005228 |
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| author | Haowen Jiang, MBBS Jie Jun Wong, MBBS Glades H.M. Tan, BEng Louis L.Y. Teo, MBBS See Hooi Ewe, MBBS, PhD Ru-San Tan, MBBS Fei Gao, PhD Angela S. Koh, MBBS, MPH, PhD |
| author_facet | Haowen Jiang, MBBS Jie Jun Wong, MBBS Glades H.M. Tan, BEng Louis L.Y. Teo, MBBS See Hooi Ewe, MBBS, PhD Ru-San Tan, MBBS Fei Gao, PhD Angela S. Koh, MBBS, MPH, PhD |
| author_sort | Haowen Jiang, MBBS |
| collection | DOAJ |
| description | Background: Among older adults, sex hormones may exert differential effects on body fat and cardiac health. Objectives: The authors aimed to study the effects of sex on body fat composition and aging-related diastolic function, as well as their longitudinal changes. Methods: Community-dwelling older adults without cardiovascular disease underwent prospective baseline same-day anthropometry for body fat mass (BFM), percentage body fat (PBF), and waist hip ratio (WHR) quantification by bioimpedance and transthoracic Doppler echocardiography, with measurements repeated at 5 years. Study outcomes included diastolic grade, ratio of early to late diastolic inflow velocities (E/A), ratio of mitral early diastolic inflow velocity to the average of septal and lateral early diastolic annular tissue velocities (E/e') ratios, left ventricle mass index, left atrial volume index and clinical outcomes. Correlations between baseline or interval changes (Δ) of WHR, BFM and PBF with follow-up or Δ values of outcomes were analyzed, with multivariable linear regression model adjustments for significant variables. Results: Among 409 older adults (mean age 61 ± 12.7 years, 214 women) with median follow-up of 4.9 (4.5, 5.2) years, baseline BFM predicted echocardiographic diastolic dysfunction at follow-up in women (OR: 1.059; 95% CI: 1.051-1.115; P = 0.002). Baseline PBF was associated with ΔE/A (β: 0.010; P = 0.028) among women and ΔE/e' (β: −0.069; P = 0.020) among men, with significant interactions between sex and PBF in predicting ΔE/A (P < 0.05). ΔBFM (β: −0.007; P = 0.05) and ΔPBF (β: −0.005; P = 0.047) were associated with ΔE/A independent of baseline BFM/PBF among women. Baseline (HR: 1.141; 95% CI: 1.027-1.158; P = 0.005) and changes in WHR (HR: 0.857; 95% CI: 0.790-0.931; P < 0.001) predicted cardiovascular outcomes among women. Conclusions: Baseline and interval increase in fat quantity via bioimpedance defined differential trajectories of longitudinal cardiac functional deteriorations between sexes. |
| format | Article |
| id | doaj-art-a2eadf01518840a797942acdd7524f8d |
| institution | Kabale University |
| issn | 2772-963X |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
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| series | JACC: Advances |
| spelling | doaj-art-a2eadf01518840a797942acdd7524f8d2025-08-23T04:50:11ZengElsevierJACC: Advances2772-963X2025-09-014910209710.1016/j.jacadv.2025.102097Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older AdultsHaowen Jiang, MBBS0Jie Jun Wong, MBBS1Glades H.M. Tan, BEng2Louis L.Y. Teo, MBBS3See Hooi Ewe, MBBS, PhD4Ru-San Tan, MBBS5Fei Gao, PhD6Angela S. Koh, MBBS, MPH, PhD7Department of Cardiology, National Heart Centre Singapore, SingaporeDepartment of Cardiology, National Heart Centre Singapore, SingaporeDepartment of Cardiology, National Heart Centre Singapore, SingaporeDepartment of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, SingaporeDepartment of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, SingaporeDepartment of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, SingaporeDepartment of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, SingaporeDepartment of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore; Address for correspondence: Dr Angela S. Koh, National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609.Background: Among older adults, sex hormones may exert differential effects on body fat and cardiac health. Objectives: The authors aimed to study the effects of sex on body fat composition and aging-related diastolic function, as well as their longitudinal changes. Methods: Community-dwelling older adults without cardiovascular disease underwent prospective baseline same-day anthropometry for body fat mass (BFM), percentage body fat (PBF), and waist hip ratio (WHR) quantification by bioimpedance and transthoracic Doppler echocardiography, with measurements repeated at 5 years. Study outcomes included diastolic grade, ratio of early to late diastolic inflow velocities (E/A), ratio of mitral early diastolic inflow velocity to the average of septal and lateral early diastolic annular tissue velocities (E/e') ratios, left ventricle mass index, left atrial volume index and clinical outcomes. Correlations between baseline or interval changes (Δ) of WHR, BFM and PBF with follow-up or Δ values of outcomes were analyzed, with multivariable linear regression model adjustments for significant variables. Results: Among 409 older adults (mean age 61 ± 12.7 years, 214 women) with median follow-up of 4.9 (4.5, 5.2) years, baseline BFM predicted echocardiographic diastolic dysfunction at follow-up in women (OR: 1.059; 95% CI: 1.051-1.115; P = 0.002). Baseline PBF was associated with ΔE/A (β: 0.010; P = 0.028) among women and ΔE/e' (β: −0.069; P = 0.020) among men, with significant interactions between sex and PBF in predicting ΔE/A (P < 0.05). ΔBFM (β: −0.007; P = 0.05) and ΔPBF (β: −0.005; P = 0.047) were associated with ΔE/A independent of baseline BFM/PBF among women. Baseline (HR: 1.141; 95% CI: 1.027-1.158; P = 0.005) and changes in WHR (HR: 0.857; 95% CI: 0.790-0.931; P < 0.001) predicted cardiovascular outcomes among women. Conclusions: Baseline and interval increase in fat quantity via bioimpedance defined differential trajectories of longitudinal cardiac functional deteriorations between sexes.http://www.sciencedirect.com/science/article/pii/S2772963X25005228cardiometabolic riskleft ventricular functionobesity |
| spellingShingle | Haowen Jiang, MBBS Jie Jun Wong, MBBS Glades H.M. Tan, BEng Louis L.Y. Teo, MBBS See Hooi Ewe, MBBS, PhD Ru-San Tan, MBBS Fei Gao, PhD Angela S. Koh, MBBS, MPH, PhD Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults JACC: Advances cardiometabolic risk left ventricular function obesity |
| title | Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults |
| title_full | Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults |
| title_fullStr | Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults |
| title_full_unstemmed | Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults |
| title_short | Sex-Dependent Effects of Body Fat on Cardiac Function and Outcomes in Community-Dwelling Older Adults |
| title_sort | sex dependent effects of body fat on cardiac function and outcomes in community dwelling older adults |
| topic | cardiometabolic risk left ventricular function obesity |
| url | http://www.sciencedirect.com/science/article/pii/S2772963X25005228 |
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