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Background: There is limited research on body composition in persons with haemophilia (PwH). The literature describes an increased body fat distribution and decreased lean mass in PwH compared to healthy controls using bioimpedance analysis. Using dual x‐ray absorptiometry (DXA), which is known to be the most accurate method, this investigation aims to postulate reference data for body composition parameters within haemophilia severity phenotypes and age groups. Methods: Persons underwent whole body DXA screening using Horizon. Body fat percentage, estimated visceral adipose tissue (VAT), appendicular fat and lean mass, and lean and fat mass in relation to body height were assessed. Haemophilia severity and five age groups were distinguished. Results: Two hundred and one persons with mild (n = 44), moderate (n = 41), or severe (n = 116) haemophilia A/B (median age 40 [28–55; 1.IQ–3.IQ] years) were analysed. The median body fat percentage was 28.7% [25.5%–33.9%] and median estimated VAT was 657 g [403–954 g] with no significant difference between severity phenotypes (p =.474; p =.781). Persons with severe haemophilia had less lean mass compared to moderate and mild haemophilia (p =.013; p =.034). Total and appendicular fat is increased in older PwH (aged ≥40 years) compared to younger PwH (aged ≤29 years; p <.05). Lean mass did not differ between age groups. Conclusion: This study provides valuable reference data for body composition parameters in PwH. Persons with severe haemophilia show significantly less lean mass compared to persons with moderate or mild haemophilia. Body fat percentage and VAT did not differ between severity phenotypes, but increased with age. [ABSTRACT FROM AUTHOR]

Nutritional compromise, low levels of vitamin D, chronic inflammation, abnormal growth, and physical inactivity affect bone metabolism and compromise long‐term bone health in individuals with epidermolysis bullosa (EB). The result is a high risk for osteopenia, osteoporosis, and pathologic fractures, but this important consequence of EB has been the focus of few investigations. Our scoping review found 21 publications that assessed the current understanding and clinical practices for monitoring of osteoporosis and its treatment in EB. Recommendations summarized from 13 of these publications include early nutritional and weight assessments before 2 years of age; bloodwork every 6–12 months starting at birth; Tanner stage assessments every 6 months to detect any pubertal delay; DEXA scans starting at age 6 years with repeated scans every 1–2 years, except in mild cases; and vitamin D supplementation of 80–320 IU daily for children 0–7 years and 720 IU for patients >8 years. [ABSTRACT FROM AUTHOR]

Background: Children spend increasing amounts of time on recreational screen media, which may lead to an obesogenic environment. Objectives: We investigated the association of trajectories of screen time across ages 3, 5 and 7 years with body composition at age 7 in the Odense Child Cohort. Methods: Data were collected in the Municipality of Odense, Denmark, between 2010 and 2019. Group‐based trajectory modelling was applied to group participants into four trajectories of prospective parent‐reported screen time. Body composition was assessed using dual‐energy x‐ray absorptiometry with calculated fat‐mass index (FMI) as the primary outcome. Primary models were linear multivariable regression models adjusted for participants' sex, age, birthweight, maternal origin, maternal education, maternal body‐mass‐index, and maternal age. Further models were adjusted for additional possible confounders. Selection bias was addressed by inverse probability weighting. Results: In total, 803 children (48.2% female) were included in the primary analysis. Participants with screen time at all time points were assigned to four trajectory groups [constant low screen time (12.7%), low increase (36.3%), high increase between ages 3 and 5 (33.5%) and high increase in screen time (17.5%)]. Sample characteristics differed across missing data status and trajectories. Mean FMI (kg/m2) and standard deviation (SD) were 3.7 (SD 1.3) and 3.9 (SD 1.6) for the constant low versus high screen time, respectively. No differences in FMI were found between screen time trajectory groups at age 7 (adjusted mean difference 0.1 kg/m2, 95% confidence interval −0.3, 0.5 for constant low versus high screen time). No consistent associations between screen time groups and secondary body composition outcomes were found. Conclusions: Results from this study do not suggest that recreational screen time from age 3 to 7 years is associated with adiposity or other measures of body composition. [ABSTRACT FROM AUTHOR]

Background: Many predictors of morbidity caused by metabolic disease are associated with body shape. 3D optical (3DO) scanning captures body shape and has been shown to accurately and precisely predict body composition variables associated with mortality risk. 3DO is safer, less expensive, and more accessible than criterion body composition assessment methods such as dual‐energy X‐ray absorptiometry (DXA). However, 3DO scanning has not been standardized across manufacturers for pose, mesh resolution, and post processing methods. Purpose: We introduce a scanner‐agnostic algorithm that automatically fits a topologically consistent human mesh to 3DO scanned point clouds and predicts clinically important body metrics using a standardized body shape model. Our models transform raw scans captured by any 3DO scanner into fixed topology meshes with anatomical consistency, standardizing the outputs of 3DO scans across manufacturers and allowing for the use of common prediction models across scanning devices. Methods: A fixed‐topology body mesh template was automatically registered to 848 training scans from three different 3DO systems. Participants were between 18 and 89 years old with body mass index ranging from 14 to 52 kg/m2. Scans were registered by first performing a coarse nearest neighbor alignment between the template and the input scan with an anatomically constrained principal component analysis (PCA) domain deformation using a device and gender specific bootstrap basis trained on 70 seed scans each. The template mesh was then optimized to fit the target with a smooth per‐vertex surface‐to‐surface deformation. A combined unified PCA model was created from the superset of all automatically fit training scans including all three devices. Body composition predictions to DXA measurements were learned from the training mesh PCA coefficients using linear regression. Using this final unified model, we tested the accuracy of our body composition models on a withheld sample of 562 scans by fitting a PCA parameterized template mesh to each raw scan and predicting the expected body composition metrics from the principal components using the learned regression model. Results: We achieved coefficients of determination (R2) above 0.8 on all nine fat and lean predictions except female visceral fat (0.77). R2 was as high as 0.94 (total fat and lean, trunk fat), and all root‐mean‐squared errors were below 3.0 kg. All predicted body composition variables were not significantly different from reference DXA measurements except for visceral fat and female trunk fat. Repeatability precision as measured by the coefficient of variation (%CV) was around 2–3x worse than DXA precision, with visceral fat %CV below 2x DXA %CV and female total fat mass at 5x. Conclusions: Our method provides an accurate, automated, and scanner agnostic framework for standardizing 3DO scans and a low cost, radiation‐free alternative to criterion radiology imaging for body composition analysis. We published a web‐app version of this work at https://shapeup.shepherdresearchlab.org/3do‐bodycomp‐analyzer/ that accepts mesh file uploads and returns templated meshes with body composition predictions for demo purposes. [ABSTRACT FROM AUTHOR]

Tetrasomy 18p is a rare chromosomal abnormality, resulting from an additional iso‐chromosome composed of two copies of the short arm. It is characterized by craniofacial abnormalities, neuromuscular dysfunction, and developmental delay. The Chromosome 18 Clinical Research Center has established the largest cohort of individuals with this rare genetic condition. Here, we describe a case series of 21 individuals with tetrasomy 18p who have a previously unreported clinical finding: low bone mineral density. Most individuals met criteria for low bone density despite being relatively young (mean age of 21 years). Clinicians providing care to individuals affected by Tetrasomy 18p should be aware of their increased risk for decreased bone density and pathological fractures. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: (i) To predict the future risk of osteoporotic fracture in women using a simple forearm radiograph. (ii) To assess osteoporosis in southern Indian women by using radiogrammetric technique in comparison with dual‐energy X‐ray absorptiometry (DXA) and X‐ray phantom study. Methods: The bone mineral density (BMD) of the right proximal femur by DXA and the X‐ray measurements were acquired from the right forearm. The combined cortical thickness at the second to fourth metacarpal region (M‐CCT), radius (R‐CCT) and ulna (U‐CCT) were derived in all the studied population. The aluminium phantom study was conducted by varying the X‐ray source to film distance at 100 cm and 150 cm, respectively. The feed forward back propagation neural network was used for classification of low bone mass group and normal. Results: The combined cortical thickness of M‐CCT, R‐CCT and U‐CCT of the total studied population was strongly correlated with DXA femur Th.BMD measurements (r = 0.77, r = 0.61 and r = 0.59 [P < 0.01]). The predicted future osteoporotic fracture risk for the low bone mass group, post‐menopausal women and old‐aged women population was found to be 92%, 62.8%, and 64.7%, respectively. The accuracy of neural network classifier for training set, testing set was found to be 97.5% and 87.5% in the studied population. Conclusion: The results suggested that M‐CCT and M‐CCT (%) at the second metacarpal region are useful in predicting the future risk of osteoporotic fracture in women. The aluminium phantom study with an X‐ray tube to film distance of 100 cm mimics an exact condition of forearm radiogrammetry. [ABSTRACT FROM AUTHOR]

Background: Metatarsal fractures, especially of the fifth metatarsal, are common injuries of the foot in a young athletic population, but the risk factors for this injury are not well understood. Dual-energy x-ray absorptiometry (DXA) provides reliable measures of regional bone mineral density to predict fracture risk in the hip and lumbar spine. Recently, sub-regional metatarsal reliability was established in fresh cadaveric specimens and associated with ultimate fracture force. The purpose of this study was to assess the reliability of DXA bone mineral density measurements of sub-regions of the second and fifth metatarsals in a young, active population. Methods: Thirty two recreationally active individuals participated in the study, and the bone density of the second (2MT) and fifth (5MT) metatarsals of each subject was measured using a Hologic QDR x-ray bone densitometer. Scans were analyzed separately by two raters, and regional bone mineral density, bone mineral content, and area measurements were calculated for the proximal, shaft, and distal regions of the bone. Intra-rater, inter-rater, and scan-rescan reliability were then determined for each region. Results: Proximal and shaft bone mineral density measurements of the second and fifth metatarsal were reliable. ICC's were variable across regions and metatarsals, with the distal region being the poorest. Conclusions: Bone mineral density measurements of the metatarsals may be a better indicator of fracture risk of the metatarsals than whole body measurements. A reliable method for measuring the regional bone mineral densities of the metatarsals was found. However, inter-rater reliability and scan-rescan reliability for the distal regions were poor. Future research should examine the relationship between DXA bone mineral density measurements and fracture risk at the metatarsals. [ABSTRACT FROM AUTHOR]

Summary: Background: Infant adiposity better predicts childhood obesity/metabolic risk than weight, but technical challenges fuel controversy over the accuracy of adiposity estimates. Objective: We prospectively measured adiposity (%fat) in term newborns (NB) at 2 weeks (n = 41) and 1 year (n = 30). Methods: %fat was measured by dual X‐ray absorptiometry (DXA), PEAPOD and skin‐folds (SF). DXAs were analyzed using Hologic Apex software 3.2(DXAv1) and a new version 5.5.2(DXAv2). Results: NB %fat by DXAv2 was 55% higher than DXAv1 (14.2% vs. 9.1%), 45% higher than SF (9.8%), and 36% higher than PEAPOD (10.4%). Among NB, Pearson correlations were 0.73–0.89, but agreement (intra‐class correlations) poor between DXAv2 and DXAv1 (0.527), SF (0.354) and PEAPOD (0.618). At 1 year, %fat by DXAv2 was 51% higher than DXAv1 (33.6% vs. 22.4%), and twice as high compared with SF (14.6%). Agreement was poor between DXAv2 and DXAv1 (0.204), and SF (0.038). The absolute increase in %fat from 2 weeks to 1 year was 19.7% (DXAv2), 13.6% (DXAv1) and only 4.8% by SF. Conclusion: Analysis of the same DXA scans using new software yielded considerably higher adiposity estimates at birth and 1 year compared with the previous version. Using different modalities to assess body composition longitudinally is problematic. Standardization is gravely needed to determine how early life exposures affect childhood obesity/metabolic risk. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the accuracy of a novel ultrasound (US) approach for lumbar spine densitometry on overweight and obese women of variable age through a clinical validation study. The US method was originally developed in women with body mass index (BMI) < 25 kg/m2. In this study, 382 female patients were recruited (45–80 years, BMI > 25 kg/m2) and underwent dual X‐ray absorptiometry (DXA) of lumbar spine (L1–L4) and an US scan of the same vertebrae L1–L4, performed with a dedicated device providing both echographic images and 'raw' radiofrequency signals. Acquired US data were analysed through a novel automatic algorithm that performed a series of spectral and statistical analyses to calculate bone mineral density employing an innovative method. Diagnostic accuracy of US investigations was quantitatively assessed through a direct comparison with DXA results. The average agreement between US and DXA diagnoses was acceptable for patients aged 45–65 years (81.5%), while a slight decrement was observed for older patients (69.6%), which can be partially due to a decrease in DXA accuracy because of age‐related degenerations. The adopted method has a potential for early osteoporosis diagnosis in people younger than 65 years, independent of their BMI. [ABSTRACT FROM AUTHOR]

Introduction As the population of patients with haemophilia ( PWH) ages, healthcare providers are required to direct greater attention to age-related co-morbidities. Low bone mineral density ( BMD) is one such co-morbidity where the incidence not only increases with age, but also occurs with greater frequency in PWH. Aim To review risk factors for low BMD, and strategies to promote bone health and identify patients who would benefit from screening for osteoporosis and subsequent treatment. Methods A narrative review of the literature was performed in MEDLINE with keywords haemophilia, bone density, osteoporosis and fracture. Reference lists of retrieved articles were also reviewed. Results Low BMD occurs more commonly in PWH than the general population and is most likely the result of a combination of risk factors. Steps to promote bone health include preventing haemarthrosis, encouraging regular exercise, adequate vitamin D and calcium intake, and avoiding tobacco and excessive alcohol intake. Adults 50 years of age and older with haemophilia and those younger than 50 years with a fragility fracture or increased fracture risk based on FRAX (The Fracture Risk Assessment Tool), regardless of haemophilia severity, should be screened for low BMD using dual x-ray absorptiometry ( DXA). Once osteoporosis is diagnosed based on DXA, fracture risk should guide treatment. Currently, treatment is similar to those without haemophilia and most commonly includes bisphosphonates. Conclusion Haemophilia care providers should promote adequate bone formation during childhood and reduce bone loss during adulthood as well as identify patients with low BMD that would benefit from therapy. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to assess bone mineral density (BMD) in a population of children and adolescents with cerebral palsy and mental retardation with or without epilepsy. Methods: One hundred thirteen patients (63 male and 50 female) were recruited for evaluation. Patients were divided in three groups: 40 patients (group 1) were affected by cerebral palsy and mental retardation; 47 (group 2) by cerebral palsy, mental retardation, and epilepsy; and 26 (group 3) by epilepsy. The control group consisted of 63 healthy children and adolescents. Patients underwent a dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine (L1-L4), and z-score was calculated for each patient; t-score was considered for patients 18 years of age and older. Key Findings: Abnormal BMD by DEXA was found in 17 patients (42.5%) in group 1, in 33 (70.2%) in group 2, and in 3 (11.5%) in group 3. In groups 1 and 2, tetraparesis and severe/profound mental retardation were related to a significantly abnormal BMD (p = 0.003). The multivariate analysis of independent factors on BMD (z-score) revealed a significant correlation between BMD (z-score) and age (p = 0.04), body mass index (BMI; p = 0.002), severe/profound mental retardation (p = 0.03), and epilepsy (p = 0.05). Significance: A significantly lower BMD z-score value was found in patients with cerebral palsy, mental retardation, and epilepsy compared with those without epilepsy. The epileptic disorder appears to be an aggravating factor on bone health when comorbid with cerebral palsy and mental retardation. [ABSTRACT FROM AUTHOR]

doi: 10.1111/j.1741-2358.2011.00527.x Relationships between bone mass and micro-architecture at the mandible and iliac bone in edentulous subjects: a dual X-ray absorptiometry, computerised tomography and microcomputed tomography study Objectives: To compare bone volume, bone mineral density, cortical thickness and bone micro-architecture in a series of paired mandibular and iliac bone samples analysed by various imagery techniques to see whether relationships exist between the various techniques and between mandibular and iliac bone. Materials and methods: Bone samples from the mandible and ilium were harvested in 20 cadavers and analysed by dual energy X-ray absorptiometry (DXA), computerised tomography (CT) on a conventional hospital machine and microCT. Results: Significant correlations were found between Hounsfield density obtained by CT, and bone mass determined by microCT but not with DXA values. Cortical thickness measurements were well correlated between CT and microCT. No relationships were found between mandibular and iliac bone, when considering mineral density, cortical thickness, bone volume or micro-architecture. Conclusion: In clinical practice, CT remains the most appropriate routine means for bone qualitative and quantitative evaluation at the mandible. In this ex vivo study, these results confirm that mandibular bone status does not reflect the axial skeletal one and assist in the placement of implants with dental prostheses in old or osteoporotic patients. [ABSTRACT FROM AUTHOR]

Many studies indicate racial differences in areal bone mineral density (aBMD). African-Americans tend to have the greatest aBMD, followed by Caucasian, Hispanic and Native Americans. Asian Americans, on average, have the lowest aBMD. Differences in aBMD are attenuated when adjustments are made for bone size, weight and lifestyle factors. While many studies have focused on racial differences in bone density, it is important to consider fracture risk since it is the clinically meaningful outcome and is determined by many factors other than bone density. African- and Asian-Americans have a relatively low risk of fracture compared to other groups, despite drastically different bone density, as measured by dual X-ray absorptiometry (DXA). Factors that cannot be completely evaluated by DXA, such as bone size, volumetric density, bone microarchitecture and turnover may be important in explaining disparate fracture rates. Newer technologies such as central quantitative computed tomography (CT) and high-resolution peripheral CT promise to contribute important knowledge in this regard. Despite recent advances, more fracture risk data is needed for non-Caucasian groups to assist in the development of relevant screening and treatment guidelines. [ABSTRACT FROM AUTHOR]

Modern populations from Norway and England differ in their experience of osteoporosis, the former showing lower bone mineral density (BMD) and a higher fragility fracture rate. The aim of the present work was to investigate whether this was also the case during the Middle Ages. Age-dependent loss of BMD in the proximal femur was assessed using dual X-ray absorptiometry (DXA) in male and female adult skeletons from a cemetery in the medieval town of Trondheim, Norway. Fracture prevalence was also investigated. Results were compared with those previously reported for a skeletal series from Wharram Percy, a deserted medieval village in England. Results indicate that peak BMD and patterns of age-related loss of BMD in the Norwegian and the English group were similar. Among females, the prevalence of osteoporotic fractures was greater in the Norwegian than in the English population. The BMD results suggest that differences in BMD between English and Norwegians are of recent origin, although given the fairly modest sample sizes, further work is needed to confirm this. Reasons for the greater prevalence of osteoporotic fractures in women in the Norwegian skeletal series are unclear, but the colder climate and greater frequency of hard surfaces may have meant that falls were more frequent, and when they occurred, were more likely to result in fractures than in the rural English group. [ABSTRACT FROM AUTHOR]

Study Objectives. To develop a model for osteoporosis screening and education in community pharmacies using a team approach, compare bone mineral density T-scores between quantitative ultrasound (QUS) and dual-energy x-ray absorptiometry (DXA), and determine patient satisfaction with this pharmacist-provided osteoporosis screening and education program. Design. Prospective, cross-sectional study. Setting. Community pharmacies and outpatient family medicine, internal medicine, and obstetrics and gynecology clinics in Amarillo, Texas. Patients. Women aged 55 years or older with no previous diagnosis of osteoporosis or osteopenia who had at least one additional risk factor for osteoporosis and had not been screened in the previous 3 years. Intervention. Patients were referred from family medicine, internal medicine, and obstetrics and gynecology clinics to a community pharmacy. Osteoporosis screening using heel QUS and education regarding disease prevention and treatment were provided by pharmacists. Screening results, recommendations for confirmatory DXA, and potential treatments options were provided to the referring physicians. Measurements and Main Results. A total of 100 patients (mean age 66.2 ± 7.9 yrs) were enrolled in the study; three were subsequently excluded. Of the 97 study patients who were screened using QUS, 45 (46%) patients were at moderate risk (T-score < -1 to > -2.5) and nine (9%) were at high risk (T-score ≤ -2.5). Of 54 patients recommended for DXA referral, 20 (37%) completed the scan. All 20 were diagnosed with either osteopenia (9 patients [45%]) or osteoporosis (11 patients [55%]). Correlation was moderate between T-scores obtained by QUS and DXA of lumbar vertebrae 1-4 (r=0.45, p=0.026). Counseling regarding risk factors, screening results, smoking cessation, calcium intake, exercise, and caffeine intake was perceived by patients as valuable or highly valuable (medians for all items ranged from 4-5 on a 5-point Likert scale). Of 84 patients assessed (13 were lost to follow-up), 81 (96%) said they would recommend this service to others. Conclusion. Osteoporosis screening and education in community pharmacies are effective in detecting undiagnosed disease and are perceived by patients as highly useful. [ABSTRACT FROM AUTHOR]

In order to determine risk factors for bone loss after renal transplantation, dual energy X-ray absorptiometry was performed in 125 renal transplant patients. The bone mineral density (BMD) was expressed as a percentage of the normal population (BMD%) and Z-score (SD from normal). The whole body, lumbar spine and femoral neck BMD% (Z-score) values were 93.9±8.9 (-0.90 SD), 91.6±14.9 (-0.98 SD) and 87±15.3 (-1.0 SD)%, respectively. Low BMD% was associated with low creatinine clearance (<40 mL/min: 91.6±7.9, >40 mL/min: 95.6±8.0, p<0.01), repeated graft loss (0: 94.4±9.1, >1: 87.4±9.3, p<0.05), long dialysis duration (<1 yr: 95.2±7.9, >5: 90.1±10.6, p<0.05), acidosis (bicarbonate <21 mmol/L: 89.6±8.0, >27: 96.7±7.2, p<0.01), secondary and tertiary hyperparathyroidism (<50 ng/L: 95.9±7.1, >200: 87.7±5.0, p<0.01), raised alkaline phosphatase (<200 units/L: 95.7±7.2, >300: 85.6±13.2, p<0.001), osteocalcin (<50 μg/L: 95.2±6.7, >100: 89.3±7.6, p<0.01) and urinary deoxypyridinoline (<5 nM/mM creatinine: femoral neck 89.6±10.7, >10: 82.1±20.1, p<0.05), low 25-OH-vitamin D (<10 μg/L: 91.3±9.8, >20: 96.9±7.4, p<0.001) and high cyclosporine concentration (0 ng/L: 98.3±7.0, >150: 92.1±9.3, p<0.05). Patients with clinical atherosclerosis (91.7±8.6 vs. 95.4±8.8, p<0.01), hypoalbuminemia (<550 μmol/L: 87.6±13.2, >550: 94.2±7.8, p<0.01), renovascular disease (89.7±5.7 vs. 95.0±5.7, p<0.05) and diabetic nephropathy (femoral neck 76.6±8.8 vs. 89.3±15.1, p<0.01) had lower bone masses. High bone mass was associated with previous dialysis alphacalcidol therapy (0: 92.2±7.5, >3 μg/wk: 97.3±6.9, p<0.05). No relationships with transplantation duration, 1,25-OH-vitamin D, aluminium, calcium or steroid dose were found. No involutional changes in tertiary hyperparathyroidism could be discerned. Conclusion. The major threats to bone mass after renal transplantation appear to be ongoing hyperparathyroid bone disease, low renal function, acidosis, systemic disease and hypo-vitaminosis D. [ABSTRACT FROM AUTHOR]

Vertebral bone mineral content was determined in a group of 56 women, ages 30-62. These measurements were compared with the status of supporting bone in the jaws (alveolar, molar and bicuspid) and with gingival health. There was a significant decline in vertebral bone mineral content from the pre- to post-menopausal group. Molar and bicuspid measurements were highly correlated. There was some association between lumbar bone mineral content and molar bone status for postmenopausal women. For postmenopausal women, the cases of greatest percent bone loss in alveolar crest were associated with lower lumbar bone mineral content. Gingival health did not confound the bone status measurements. The 56 subjects did not exhibit the degree of reduction in bone density that is observed in the general population. Further investigation using these radiographic techniques may reveal a link between substantial bone loss in the jaw and moderate to severe bone loss in the lumbar vertebrae. [ABSTRACT FROM AUTHOR]

Background: Obesity may increase heart failure risk through cardiac remodeling. Cross-sectional associations between adiposity and cardiac structure and function have been elucidated, but the impact of longitudinal changes in adiposity on cardiac remodeling is less well understood., Methods and Results: Participants in the Dallas Heart Study without cardiovascular disease or left ventricular dysfunction underwent assessment of body weight, anthropometrics, and cardiac magnetic resonance imaging at baseline and 7 years later. Associations between changes in indices of generalized and central adiposity with changes in left ventricular mass, volume, mass/volume ratio (concentricity), wall thickness, and ejection fraction were assessed using multivariable linear regression. The study cohort (n=1262) mean age was 44 years with 57% women, 44% black, and 36% obese participants. At follow-up, 41% had ≥5% weight gain, and 15% had ≥5% weight loss. Greater weight gain was associated with younger age, lower risk factor burden, and lower body mass index at baseline. In multivariable models adjusting for age, sex, race, comorbid conditions at baseline and follow-up, baseline adiposity, and cardiac measurement, increasing weight was associated with increases in left ventricular mass (β=0.10, P <0.0001), wall thickness (β=0.10, P <0.0001), and concentricity (β=0.06, P =0.002), with modest effects on end-diastolic volume (β=0.04, P =0.044) and ejection fraction (β=0.05, P =0.046). Similar results were seen with other adiposity indices., Conclusions: Concentric left ventricular remodeling is the predominant phenotype linked to increasing adiposity in middle age. Our findings support the importance of weight management to prevent secular changes in adiposity, concentric remodeling, and eventual heart failure over time., (© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)