Metabolic mediators of the relationship between adiposity and cardiac structure and function in UK adolescents - 05/07/18
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Résumé |
Introduction |
Strong evidence shows that adiposity increases cardiovascular disease (CVD) risk, explained in part by blood pressure (BP), glucose, triglycerides and cholesterol. Metabolomics offers the potential to identify novel intermediate pathways.
Methods |
Body mass index (BMI) was measured at age 11 in the Avon Longitudinal Study of Parents and Children. Measures of cardiac structure (precursors of CVD; age 17) were left atrial size indexed to height (LAI), left ventricular mass indexed to height2.7 (LVMI), relative wall thickness (RWT) and left ventricular internal diameter (LVIDD). Metabolic traits (mostly lipid and lipoprotein related) were quantified via high-throughput 1H-nuclear magnetic resonance spectroscopy (NMR) at age 15. Complete data was available for all exposures, mediators and outcomes (n=772). Multiple imputation was used to deal with missing data in covariates. Multivariable linear regression was used to estimate associations of BMI with measures of cardiac structure. Mediation was assessed via controlled direct and natural indirect effects, firstly, considering 156 metabolic measures individually, and secondly considering all metabolites jointly (as principle components, npc=17). Bootstrapping was used to calculate robust standard errors.
Results |
A one-unit higher BMI was associated with 0.74 (0.54, 0.94) higher LVMI in males; 0.68 (0.52, 0.84) in females. Individually, each metabolite explained little of this association. Jointly, the PCs of the metabolites explained 8% of the association in males and 0.8% in females. Similar results were seen for LAI and LVIDD. There was weak evidence of an association of BMI on RWT.
Conclusion |
In this adolescent population, individual metabolites measured by NMR contribute a small amount to the pathway from adiposity to cardiac structure. Considering them jointly indicates they may play a role in the pathway, particularly in males; further work is warranted to assess causality.
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Vol 66 - N° S5
P. S260 - juillet 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.