Gene and metabolite expression dependence on body mass index in human myocardium

Adewale S. Adebayo, Marius Roman, Mustafa Zakkar, Syabira Yusoff, Melanie Gulston, Lathishia Joel-David, Bony Anthony, Florence Y. Lai, Antonio Murgia, Bryony Eagle-Hemming, Sophia Sheikh, Tracy Kumar, Hardeep Aujla, Will Dott, Julian L. Griffin, Gavin J. Murphy, Marcin J. Woźniak*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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We hypothesized that body mass index (BMI) dependent changes in myocardial gene expression and energy-related metabolites underlie the biphasic association between BMI and mortality (the obesity paradox) in cardiac surgery. We performed transcriptome profiling and measured a panel of 144 metabolites in 53 and 55, respectively, myocardial biopsies from a cohort of sixty-six adult patients undergoing coronary artery bypass grafting (registration: NCT02908009). The initial analysis identified 239 transcripts with biphasic BMI dependence. 120 displayed u-shape and 119 n-shape expression patterns. The identified local minima or maxima peaked at BMI 28–29. Based on these results and to best fit the WHO classification, we grouped the patients into three groups: BMI < 25, 25 ≤ BMI ≤ 32, and BMI > 32. The analysis indicated that protein translation-related pathways were downregulated in 25 ≤ BMI ≤ 32 compared with BMI < 25 patients. Muscle contraction transcripts were upregulated in 25 ≤ BMI ≤ 32 patients, and cholesterol synthesis and innate immunity transcripts were upregulated in the BMI > 32 group. Transcripts involved in translation, muscle contraction and lipid metabolism also formed distinct correlation networks with biphasic dependence on BMI. Metabolite analysis identified acylcarnitines and ribose-5-phosphate increasing in the BMI > 32 group and α-ketoglutarate increasing in the BMI < 25 group. Molecular differences in the myocardium mirror the biphasic relationship between BMI and mortality.

Original languageEnglish
Article number1425
Number of pages13
JournalScientific Reports
Issue number1
Publication statusPublished - Jan 2022

Bibliographical note

Van Geest Foundation, Leicester NIHR Biomedical Research Centre, British Heart Foundation CH/12/1/29419, AA18/3/34220.
Competing interests
Mrs. Kumar, Prof. Murphy and Dr Woźniak received a grant from Zimmer Biomet. Dr Murphy also received grants from Terumo and Baxter. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Data Availability Statement

Supplementary Information The online version contains supplementary material available at


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