There seems to be an independent association between adiposity and heart function in patients with Duchenne muscular dystrophy (DMD), according to a new study published in the Journal of the American Heart Association.

This finding suggests that preventing adiposity may reduce the development of heart dysfunction in these patients. Adiposity is defined as obesity or the state of being fat.

Limited mobility and the use of corticosteroids often lead to adiposity in patients with DMD. These patients also develop cardiomyopathy, especially during the later stages of the disease.

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A team of researchers was led by Tarek Alsaied MD, MSc, a pediatric cardiologist from the University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh in Pennsylvania. They determined the association between adiposity and cardiovascular dysfunction in DMD by retrospectively reviewing 324 DMD patients who underwent both cardiac MRI and dual‐energy x‐ray absorptiometry within 1 year. 

They found that a little more than half of the patients (52%) had late gadolinium enhancement, which is a predictor of an adverse cardiovascular outcome. A little more than a third (36%) of patients had cardiac dysfunction. 

When they correlated cardiac dysfunction with adiposity, the researchers found that patients with cardiac dysfunction had higher levels of whole-body fat mass indexed to height and body mass index. This was the case regardless of age, late gadolinium enhancement, and the duration of corticosteroid use. 

Moreover, an increased whole-body fat mass indexed to height and to the percentage of body fat were associated with late gadolinium enhancement regardless of age and cardiac dysfunction.

The authors noted that body mass index did not correlate with heart dysfunction or late gadolinium enhancement and is therefore unhelpful in assessing adiposity in patients with DMD who lost the ability to walk. This is because surrogate measures of height were used in these patients.


Henson SE, Lang SM, Khoury PR, et al. The effect of adiposity on cardiovascular function and myocardial fibrosis in patients with Duchenne muscular dystrophy. J Am Heart Assoc. 2021;5;10(19):e021037. doi:10.1161/JAHA.121.021037