Objective: 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. Adipocytes and VAT are able to produce large amounts of monocyte chemoattractant protein 1 (MCP-1), a chemokine directly involved in ventricular remodeling. Design: In this study, the possible existence of a correlation between MCP-1, abdominal fat accumulation and echocardiographic abnormalities in uncomplicated obesity was investigated. Methods: Echocardiographic parameters, MCP-1 and C-reactive protein (CRP) levels were assessed in 27 normotensive obese women of fertile age (body mass index 43.5±4.8 kg/m2, mean±S.D.) and 15 normal weight women. Visceral fat (VAT) in the obese group was assessed by computed tomography. Results: Obese patients had higher MCP-1 (P <0.0001) and CRP (P <0.0001) levels than controls. MCP-1 levels were correlated with VAT area (r=0.57, P <0.0001), CRP (P <0.0001), left ventricular mass (LVM) (P <0.02), LVM indexed for height (P <0.03), end-diastolic posterior wall (P <0.005), relative wall thickness (P <0.01), early diastolic filling wave velocity (P <0.01), isovolumetric relaxation time (P <0.001) and deceleration time (P <0,01). Obese patients with greater amounts of VAT (> 130 cm2) presented higher MCP-1 (P <0.0001) and CRP levels (P <0.04) than those with a lower degree of abdominal adiposity. Conclusions: MCP-1 levels and visceral adipose tissue seem to be associated with some morphological and functional echocardiographic abnormalities and support a role for visceral fat in predisposing the subject to cardiac dysfunction, possibly through a low-grade state of inflammation.
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