Abstract
Background Laboratory data suggest obesity is linked to myocardial inflammation and fibrosis, but clinical data are limited. We aimed to examine the association of obesity with galectin-3, a biomarker of cardiac inflammation and fibrosis, and the related implications for heart failure (HF) risk. Methods and Results We evaluated 8687 participants (mean age 63 years; 21% Black) at ARIC (Atherosclerosis Risk in Communities) Visit 4 (1996-1998) who were free of heart disease. We used adjusted logistic regression to estimate the association of body mass index (BMI) categories with elevated galectin-3 (≥75th sex-specific percentile) overall and across demographic subgroups, with tests for interaction. We used Cox proportional hazards models to assess the combined associations of galectin-3 and BMI with incident HF (through December 31, 2019). Higher BMI was associated with higher odds of elevated galectin-3 (odds ratio [OR], 2.32; 95% CI, 1.88-2.86) for severe obesity ([BMI ≥35 kg/m 2] versus normal weight [BMI 18.5-<25 kg/m 2]). There were stronger associations of BMI with elevated galectin-3 among women versus men and White versus Black participants (both P-for-interaction <0.05). Elevated galectin-3 was similarly associated with incident HF among people with and without obesity (HR, 1.49; 95% CI, 1.18-1.88; and HR, 1.71; 95% CI, 1.38-2.11, respectively). People with severe obesity and elevated galectin-3 had >4-fold higher risk of HF (HR, 4.19; 95% CI, 2.98-5.88) than those with normal weight and galectin-3 <25th percentile. Conclusions Obesity is strongly associated with elevated galectin-3. Additionally, the combination of obesity and elevated galectin-3 is associated with marked HF risk, underscoring the importance of elucidating pathways linking obesity with cardiac inflammation and fibrosis.
Original language | English (US) |
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Article number | e023238 |
Journal | Journal of the American Heart Association |
Volume | 11 |
Issue number | 9 |
DOIs | |
State | Published - May 3 2022 |
Bibliographical note
Funding Information:Dr Ballantyne received grant/research support from and is a consultant for Abbott Diagnostics who also provided the reagents for galectin-3 measurement. Dr Hoogeveen received a research grant from Denka Seiken (significant). Drs Hoogeveen, Nambi, and Ballantyne are named on provisional patent no. 61721475 entitled “Biomarkers to Improve Prediction of Heart Failure Risk” filed by Baylor College of Medicine and Roche (modest). The other authors report no conflicts.
Funding Information:
The ARIC study has been funded in whole or in part with federal funds from the National Heart, Lung, and Blood Institute (NHLBI); the National Institutes of Health (NIH); and the Department of Health and Human Services, under contract numbers HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, and HHSN268201700004I. Dr Selvin was supported by NIH/National Institute of Diabetes and Digestive and Kidney Diseases grants K24DK106414 and R01DK089174. Dr Ndumele was supported by NIH/NHLBI grant R01 HL146907 and AHA grant 20SFRN35120152. Dr Echouffo-Tcheugui was supported by NIH/NHLBI grant K23 HL153774.
Publisher Copyright:
© 2022, American Heart Association Inc.. All rights reserved.
Keywords
- biomarkers
- galectin-3
- heart failure
- obesity
- Heart Failure/epidemiology
- Galectin 3/blood
- Humans
- Middle Aged
- Male
- Inflammation
- Obesity/diagnosis
- Obesity, Morbid
- Blood Proteins
- Fibrosis
- Female
- Galectins
PubMed: MeSH publication types
- Research Support, Non-U.S. Gov't
- Research Support, U.S. Gov't, P.H.S.
- Journal Article
- Research Support, N.I.H., Extramural