title: Sex differences in obesity-related changes in left ventricular morphology: the Strong Heart Study.
abstract: OBJECTIVE
  It is unclear whether there are sex differences in the relations of left ventricular mass to body composition and fat distribution in nonobese or obese hypertensive and nonhypertensive individuals and whether the obesity-related increase in left ventricular mass is similar in men and women.
  
  
  METHODS
  We examined sex differences in the relations between left ventricular mass and both body composition and fat distribution, in the presence or absence of obesity in 1068 men and 1851 women (65%) of the Strong Heart Study cohort, without prevalent cardiovascular disease or severe chronic kidney disease. Fat-free mass (FFM) and adipose mass were estimated by bioelectric impedance analysis and fat distribution by waist-to-hip ratio (WHR).
  
  
  RESULTS
  Adipose mass was significantly higher in women than in men for any weight category (P < 0.0001). After adjusting for age, hypertension, systolic blood pressure (BP) and diabetes, both left ventricular mass/height (LVMi) and left ventricular mass (LVM)/FFM were greater in obese women than obese men (P < 0.0001). Relative wall thickness was also greater in women than in men (P < 0.0001). LVM was independently related to Doppler-stroke volume, FFM and systolic BP in both sexes, with WHR and adipose mass contributing to variance of LVM in women but not in men (both P < 0.03).
  
  
  CONCLUSIONS
  Obesity influences left ventricular geometry substantially more in women than in men, possibly due to biological factors specifically associated with female adiposity.
authors.affiliation: Weill Cornell Medical College, New York, USA. simogi@unina.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Simone
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: Marcello
authors.initials: M
authors.lastname: Chinali
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Roman
authors.forename: Ana
authors.initials: A
authors.lastname: Barac
authors.forename: Julio A
authors.initials: JA
authors.lastname: Panza
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000473:pathology*; D012737:Sex Factors