title: Association between Hepatic Triglyceride Content and Left Ventricular Diastolic Function in a Population-based Cohort: The Netherlands Epidemiology of Obesity Study.
abstract: OBJECTIVE
  To investigate the association between hepatic triglyceride content and left ventricular (LV) diastolic function while taking potential confounding factors into account, including the components of the metabolic syndrome.
  
  
  METHODS
  The study was approved by the institutional review board, and all participants gave informed consent. In this cross-sectional analysis of baseline data from the Netherlands Epidemiology of Obesity study, a population-based, prospective cohort study, participants (45% men; mean age ± standard deviation, 55.3 years ± 6.2) underwent magnetic resonance (MR) spectroscopy and MR imaging to assess hepatic triglyceride content and LV diastolic heart function (ratio of peak filling rates of the early filling phase and atrial contraction [E/A ratio]). Multivariate linear regression analysis was performed while adjusting for confounding factors, and results were additionally stratified according to body mass index.
  
  
  RESULTS
  Adjustment for age, sex, heart rate, alcohol consumption, pack-years of smoking, all components of the metabolic syndrome, and visceral adiposity attenuated crude observed associations. A 10-fold increase in hepatic triglyceride content was associated with a change in mean E/A ratio of -0.004 (95% confidence interval [CI]: -0.134, 0.125) in the total study population, -0.194 (95% CI: -0.430, 0.042) in the normal-weight subgroup, 0.079 (95% CI: -0.090, 0.248) in the overweight subgroup, and -0.109 (95% CI: -0.186, -0.032) in the obese subgroup.
  
  
  CONCLUSIONS
  Fatty liver itself could, at least in obesity, pose a risk of myocardial dysfunction above and beyond known cardiovascular risk factors that are clustered within the metabolic syndrome. The association in the obese subgroup was small, and future studies with larger samples sizes are required to investigate to what extent the association exists and differs in normal-weight, overweight, and obese persons to unravel its clinical relevance.
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Widya
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Renée
authors.initials: R
authors.lastname: de Mutsert
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Martin
authors.initials: M
authors.lastname: den Heijer
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Saskia
authors.initials: S
authors.lastname: le Cessie
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
authors.affiliation: From the Departments of Radiology (R.L.W., A.d.R., H.J.L.), Endocrinology (R.L.W., J.W.A.S.), Clinical Epidemiology (R.d.M., M.d.H., S.l.C., F.R.R.), Medical Statistics and Bio-informatics (S.l.C.), Thrombosis and Haemostasis (F.R.R.), and Cardiology (J.W.J.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
authors.forename: Hildo J
authors.initials: HJ
authors.lastname: Lamb
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003971:Diastole; D005234:Fatty Liver / Q000378:metabolism*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D014280:Triglycerides / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology / Q000503:physiopathology*
chemical_list: D014280:Triglycerides