Proinflammatory cytokines and cardiac abnormalities in uncomplicated obesity: relationship with abdominal fat deposition.

ABSTRACT

BACKGROUND AND AIM: Obesity can be considered a state of chronic, low-grade inflammation. Particularly, visceral adipose tissue (VAT) seems to be an active compartment in pro-inflammatory molecule secretion. The possible existence of a correlation between circulating cytokines, their soluble receptors, abdominal fat accumulation and echocardiographic abnormalities in uncomplicated obesity was investigated. METHODS AND RESULTS: Echocardiographic parameters, C-reactive protein (CRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6-R), tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptor I (TNFR-I) were assessed in 27 normotensive obese women (age 33.3+/-8.3 years; BMI 43.5+/-4.8 kg/m2) and 15 normal-weight controls (age 36.8+/-8.2 years; BMI 22.6+/-1.7 kg/m2). VAT was assessed by CT. The obese patients had higher serum IL-6 (p<0.01), sIL-6-R (p<0.0001), sIL-6-R/IL-6 complex (p<0.05), TNF-alpha (p<0.02), sTNF-alpha-RI (p<0.03) and CRP (p<0.0001) levels than normal women. Moreover, end-diastolic septum thickness (SW), end-diastolic posterior wall thickness (PW), absolute and indexed left ventricular mass, deceleration time (DT), myocardial performance index (MPI) and isovolumetric relaxation time (IVRT) were correlated with sIL-6-R, sIL-6-R/IL-6 complex and CRP levels. Interestingly, sIL-6-R, sIL-6-R/IL-6 complex, CRP, SW, PW, DT and MPI were higher in patients with a VAT area >130 cm2 than those with <130 cm2. CONCLUSION: In normotensive obese women several pro-inflammatory molecules correlate with both echocardiographic abnormalities and the amount of intra-abdominal fat; these results may support a role for visceral fat in predisposing to cardiac dysfunction, possibly through a low-grade state of inflammation.