The prevalence and clinical impact of obesity in adults with Marfan syndrome.
BACKGROUND
Patients with Marfan syndrome characteristically have an asthenic body habitus and are considered to be exempt from the obesity epidemic.


OBJECTIVE
To examine the prevalence and clinical impact of obesity in a cohort of adults with Marfan syndrome.


METHODS
Fifty outpatients (30 female) with a mean (+/- SD) age of 38+/-13 years were studied. Demographic variables including previously identified risk factors for aortic dissection were recorded. Body mass index (BMI) was determined and patients were classified as normal (BMI less than 25 kgm2), overweight (BMI 25 kgm2 to 29.9 kgm2) or obese (BMI 30 kgm2 or greater). Other cardiovascular risk factors were examined. An adverse clinical outcome was defined as either the attainment of surgical criteria for aortic root replacement or the presence of aortic dissection.


RESULTS
A family history of aortic dissection was present in 13 (26%) patients. In 23 (46%) patients, there was no known family history of Marfan syndrome. Mean BMI was 25.4+/-7.4 kgm2, with 18 (36%) patients having an elevated BMI. Positive smoking status was present in 15 (30%), hypertension in 13 (26%) and hyperlipidemia in 19 (38%) patients. Adverse clinical outcome was present in 27 (54%) patients. Logistic regression analysis revealed only index case (OR 44; P<0.001) and higher BMI (OR 1.2; P=0.04) to be significantly and independently associated with increased risk of adverse clinical outcome.


CONCLUSIONS
Obesity is common in adults with Marfan syndrome and is associated with an increased risk of aortic complications.
Yetman
Anji T
AT
University of Utah, Primary Children's Medical Center, Salt Lake City, 84108, USA. angela.yetman@imail.org
McCrindle
Brian W
BW
D000328:Adult; D000784:Aortic Dissection / Q000453:epidemiology; D001014:Aortic Aneurysm / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008382:Marfan Syndrome / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
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