Association of Changes in Abdominal Fat Quantity and Quality With Incident Cardiovascular Disease Risk Factors

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• 作者：Jane J. Lee ; PhD^a ; Alison Pedley ; PhD^a ; Udo Hoffmann ; MD ; MPH^b ; Joseph M. Massaro ; PhD^c ; Caroline S. Fox ; MD ; MPH^a ; ^d ; ^{foxca@nhlbi.nih.gov" class="auth_mail" title="E-mail the corresponding author}
• 关键词：cardiovascular disease ; computed tomography ; epidemiology ; fat attenuation ; subcutaneous adipose tissue ; visceral adipose tissue
• 刊名：Journal of the American College of Cardiology
• 出版年：2016
• 出版时间：4 October 2016
• 年：2016
• 卷：68
• 期：14
• 页码：1509-1521
• 全文大小：918 K

文摘

Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) are associated with adverse cardiometabolic risk profiles.

Objectives

This study explored the degree to which changes in abdominal fat quantity and quality are associated with changes in cardiovascular disease (CVD) risk factors.

Methods

Study participants (n = 1,106; 44.1% women; mean baseline age 45.1 years) were drawn from the Framingham Heart Study Third Generation cohort who participated in the computed tomography (CT) substudy Exams 1 and 2. Participants were followed for 6.1 years on average. Abdominal adipose tissue volume in cm³ and attenuation in Hounsfield units (HU) were determined by CT-acquired abdominal scans.

Results

The mean fat volume change was an increase of 602 cm³ for SAT and an increase of 703 cm³ for VAT; the mean fat attenuation change was a decrease of 5.5 HU for SAT and an increase of 0.07 HU for VAT. An increase in fat volume and decrease in fat attenuation were associated with adverse changes in CVD risk factors. An additional 500 cm³ increase in fat volume was associated with incident hypertension (odds ratio [OR]: 1.21 for SAT; OR: 1.30 for VAT), hypertriglyceridemia (OR: 1.15 for SAT; OR: 1.56 for VAT), and metabolic syndrome (OR: 1.43 for SAT; OR: 1.82 for VAT; all p < 0.05). Similar trends were observed for each additional 5 HU decrease in abdominal adipose tissue attenuation. Most associations remained significant even after further accounting for body mass index change, waist circumference change, or respective abdominal adipose tissue volumes.

Conclusions

Increasing accumulation of fat quantity and decreasing fat attenuation are associated with worsening of CVD risk factors beyond the associations with generalized adiposity, central adiposity, or respective adipose tissue volumes.