DXA-measured truncal adiposity in adolescence but not in childhood longitudinally predicts worsening cardiac outcomes

BACKGROUND: Longitudinal evidence on the dual-energy X-ray absorptiometry measures of body composition from childhood with changes in cardiac structure and function in youth is scarce. OBJECTIVES: This study examined whether the increase in total and trunk fat mass during growth from childhood is associated with progressive cardiac remodeling and whether increased systolic blood pressure and inflammation explained the associations. METHODS: From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 1803 children aged 9 years who had repeated dual-energy X-ray absorptiometry-measured fat mass at ages, 9, 11, 15, and 17 and 24 years clinic visits were included. Echocardiography at 17 and 24 years assessed left ventricular mass indexed for height2.7 (LVM). RESULTS: Each unit increase of total fat mass from age 9-24 years (β = -0.48 g/m2.7 [95% CI, -0.50--0.48], P < .001) and trunk fat mass (-0.78 g/m2.7 [-0.83 to -0.74], P < .001) were independently associated with progressively decreased LVM over 7 years. However, each unit increase of total fat mass from age 17-24 years (β = 0.12 g/m2.7 [95% CI, 0.09-0.15], P < .001) and trunk fat mass (0.23 g/m2.7 [0.18-0.28], P < .001) were independently associated with increased LVM. Each unit increase of lean mass from age 9-24 years (β = 0.31 g/m2.7 [95% CI, 0.29-0.33], P < .001) and body mass index (0.24 g/m2.7 [0.20-0.27], P < .001) were independently associated with increased LVM. Increased systolic blood pressure and high-sensitivity C-reactive protein partly mediated (10.6% and 7.4% mediation, respectively), the association between increased fat mass and increased cardiac mass during growth from adolescence to young adulthood. CONCLUSIONS: Increased total and trunk fat mass from adolescence but not from childhood predicted progressive cardiac structural and functional pathologies by young adulthood.